Infectious mononucleosis is a clinical syndrome caused by Epstein-Barr virus, but other viruses can also cause similar symptoms.
-The virus is transmitted through bodily fluids such as saliva (‘kissing disease) and sputum
-It occurs mainly in adolescents and young adults
Symptoms & Signs
-It is characterized by a triad of fever, pharyngitis, and lymphadenopathy.
-Other symptoms include malaise, anorexia, myalgia, transient bilateral upper lid edema (Hoagland sign), radiation of pain to the left shoulder (Kehr’s sign) and splenomegaly
-Highly suggestive findings: Epitrochlear adenopathy, posterior cervical lymphadenopathy
-A morbilliform or papular rash, usually on the arms or trunk
–Antibody Tests: The most commonly performed diagnostic test is a rapid heterophile antibody test (Monospot test)
–White blood cell counts: Increased number of circulating white blood cells with a predominance of lymphocytes
–Other labs: Elevated aminotransferases
-The typical illness is self-limited and most symptoms resolve within 2–4 weeks.
-Symptomatic treatment: Antipyretics, analgesics, oral fluids, rest
-Misdiagnosing it as Strep throat and treating with amoxicillin can result in patient getting a rash and you getting a disappointed patient and their parents
-Upper airway obstruction and severe hematologic complications: Consider corticosteroids
-Potential complications: Splenic rupture, airway obstruction, pneumonitis, hemolytic anemia, thrombocytopenia, aplastic anemia, encephalitis, optic neuritis, meningitis, Guillain-Barré syndrome
– Patients should avoid contact sports and heavy lifting for 4 weeks due to the risk of splenic rupture