Infectious Mononucleosis

Question 1

What is this also called?

Answer 1

Glandular fever

Question 2

What virus causes this?

Answer 2

EBV - Human Herpes Virus 4

Question 3

Presentation:

What systemic symptoms? - 3

They get pharyngitis.

• What becomes enlarged?
• Group A strep also causes pharyngitis. What symptoms will be present in group A strep which won’t be present in IM?

Why do they get splenomegaly?

Answer 3

Fever - low grade
Fatigue/malaise
Anorexia

Tonsil enlargement

Rhinorrhoea
Congestion
Cough

Rash presenting with infectious mononucleosis. Splenomegaly in IM occurs as a result of lymphocytic infiltration enlarging the spleen beyond protection from the rib cage and creating an organ that is susceptible to rupture either spontaneously or traumatically.

Question 4

Investigations:

Bloods:
- What in the blood will be raised which differentiates IM from group A strep?

What is used to diagnose it?

What can be used to rule out Group A strep in
pharyngitis?

What can be done for splenomegaly?

Answer 4

Raised ESR in IM

Antibody tests
EBV antibodies
EBV PCR

Throat swab

USS

Question 5

Management:

Usually self-resolves!!!

What can be given for fever or pain?

What can be given if there is airway obstruction (pharyngitis)?

Why should contact sports and alcohol be avoided for 8 wks

Answer 5

Paracetamol

Prednisolone

To prevent splenic rupture