Infectious Mononucelosis

Question 1

What is infectious mononucleosis also known as?

Answer 1

Glandular fever

Question 2

What cause glandular fever?

Answer 2

EBV

Epstein-Barr Virus in 90% of cases

Question 3

What is the triad of symptoms in infectious mono?

Answer 3

Sore throat
Pyrexia
Lymphadenopathy

Question 4

How does the lymphadenopathy in mono contrast to that in tonsillitis?

Answer 4

Mono - anterior + posterior triangles of neck

Tonsillitis - upper anterior cervical chain

Question 5

What are other presenting features of mono?

Answer 5

malaise, anorexia, headache
palatal petechiae
splenomegaly 
hepatitis, transient rise in ALT
lymphocytosis
haemolytic anaemia secondary to cold agglutins (IgM)
a maculopapular, pruritic rash

Question 6

How is mono diagnosed?

Answer 6

Heterophil antibody test

Anti EBV antibodies

Question 7

How is mono managed?

Answer 7

Supportive
Rest, fluids, analgesia
Avoid sports for 4 weeks to avoid splenic rupture

Question 8

What are the rare complications of mono?

Answer 8

Severe upper airway obstruction

Splenic rupture

Fulminant hepatitis

Encephalitis

Severe thrombocytopaenia

Haemolytic anaemia

Question 9

How is EBV transmitted?

Answer 9

Saliva

‘kissing’