Glandular Fever (Infectious Mononucleosis)

Question 1

TOM TIP

Answer 1

Look out for exam question that describes an adolescent with sore throat, who develops an itchy rash after taking amoxicillin. Mononucleosis causes an intensely itchy maculopapular rash in response to amoxicillin or cefalosporins

Question 2

Epidemiology

Answer 2

15-25 years

Question 3

Pathophysiology

Answer 3

EBV secreted in saliva of infected individuals + can be infectious several weeks before the illness begins and intermittently for remainder of patients life
most people infected with EBV as children = v. few symptoms
when infection occurs in teens/ young adults = severe

Question 4

Signs and symptoms

Answer 4

CLASSIC TRIAD:
- Fever
- Pharyngitis
- Lymphadenopathy
Other
- Fatigue
- Tonsillar enlargement
- Splenomegaly (rare = splenic rupture)
- Atypical lymphocytosis

Question 5

Diagnosis

Answer 5

FBC + blood film
- atypical lymphocytes
Positive heterophile antibody test
- monospot test
- paul-bunnel test
Specific antibody test
- IgM (acute)
- IgG = persists after + suggests immunity

Question 6

Treatment

Answer 6

Supportive care
Corticoid steroid (PREDNISOLONE) = patients with upper airway obstruction or haemolytic anaemia