Infectious Mononucleosis

Question 1

Define infectious mononucleosis.

Answer 1

Infectious mononucleosis (IM), also known as glandular fever, is a clinical syndrome most commonly caused by Epstein Barr virus (EBV) infection.

Question 2

Explain the aetiology/risk factors of infectious mononucleosis.

Answer 2

Kissing
Sexual behaviour

Question 3

Summarise the epidemiology of infectious mononucleosis.

Answer 3

Historical data suggest that the incidence of IM ranges from 50 to 100 cases per 100,000 population, and peaks between 15 and 19 years of age.

Question 4

Recognise the presenting symptoms of infectious mononucleosis. Recognise the signs of infectious mononucleosis on physical examination.

Answer 4

Cervical or generalised lymphadenopathy
Pharyngitis
Malaise
Fever
Splenomegaly

Question 5

Identify appropriate investigations for infectious mononucleosis and interpret the results.

Answer 5

FBC
Heterophile antibodies
EBV-specific antibodies
Real-time PCR
CT abdomen

Question 6

Generate a management plan for infectious mononucleosis.

Answer 6

1st line: Paracetamol/ibuprofen

Plus:
Corticosteroid or intravenous immunoglobulin

Question 7

Identify the possible complications of infectious mononucleosis and its management.

Answer 7

Splenic rupture
Neurological complications
Chronic active EBV infection
Autoimmune diseases, non-haematological
Malignancy
Fatigue
Renal complications

Question 8

Summarise the prognosis for patients with infectious mononucleosis.

Answer 8

The prognosis for healthy people with IM is very good. Death occurs rarely, and is usually caused by airway obstruction, splenic rupture, neurological complications, haemorrhage, or secondary infection.