Infectious Mononucleosis

Question 1

Definition

Answer 1

AKA Glandular Fever most commonly caused by Epstein-Barr Virus. Manifests in children with classic triad of fever, pharyngitis, and lymphadenopathy

Question 2

Transmission

Answer 2

Saliva = kissing or sharing food
Sexual contact = blood and semen
Blood transfusions
Organ transplant
Intrauterine transmission

Question 3

Epidemiology

Answer 3

• Young adults: 15-24
• Sharing drinks/toothbrushes
• Sexual contact: Epstein-Barr Virus
• Blood transfusion/Organ transplant

Question 4

Signs

Answer 4

• Tonsillar enlargement: may have a white exudate + palatal petechiae
• Lymphadenopathy: typically bilateral posterior cervical lymphadenopathy
• Splenomegaly and hepatomegaly

Question 5

Symptoms

Answer 5

• Sore throat
• Abdominal tenderness
• Prodromal symptoms such as:
  = Malaise
  = Fever
  = Fatigue
  = Myalgia
  = Anorexia
  = Retro-orbital headache
  Widespread non-blanching maculopapular rash: if administered amoxicillin or ampicillin

Question 6

Diagnosis

Answer 6

• FBC: > 20% atypical/reactive lymphocytes or a lymphocytosis
• GOLD STANDARD = Monospot test (heterophile antibodies ): tested in the 2nd week of symptoms

Question 7

Treatment

Answer 7

First-line:
- Conservative measures: such as oral fluids and paracetamol/ibuprofen as required for relief of fever and pain
- Avoid heavy lifting : for the first month of the illness to reduce the risk of splenic rupture

Question 8

Admission

Answer 8

• Stridor,
• Dehydration
• Difficulty swallowing fluids,
• Or a complication of infectious mononucleosis, such as a splenic rupture

Question 9

Complications

Answer 9

• Fatigue
• Splenic rupture
• Upper airway obstruction