Infectious Mononucleosis (IM)

Also known as ‘glandular fever’, it’s a clinical syndrome typically caused by the Epstein-Barr virus (EBV) and characterised by fever, sore throat, and lymphadenopathy.

• Most commonly due to Epstein-Barr virus (EBV).

• Less frequently, caused by cytomegalovirus (CMV) or other agents.

• Fever.

• Pharyngitis (sore throat) – may resemble streptococcal pharyngitis.

• Cervical lymphadenopathy.

• Fatigue.

• Palatal petechiae.

• Splenomegaly.

• Skin rash, especially if exposed to ampicillin or amoxicillin.

• Monospot test (Paul-Bunnell test): Detects heterophile antibodies, positive in most cases.

• Full blood count: Lymphocytosis with atypical lymphocytes.

• EBV-specific serology: For definitive diagnosis.

• Liver function tests: Can show elevated liver enzymes.

• Throat swab: To rule out other causes like streptococcal infection.

• Mostly supportive: Analgesics, antipyretics (like paracetamol).

• Avoid contact sports or heavy lifting due to risk of spleen rupture.

• Stay hydrated and get adequate rest.

• Avoid giving ampicillin or amoxicillin due to rash risk.

• Corticosteroids: Reserved for complications like severe throat obstruction or haemolytic anaemia.

• No vaccine available for EBV.

• Avoid sharing utensils, straws, or contact with an infected person’s saliva.

• Splenic rupture: Rare but life-threatening.

• Hepatitis.

• Haemolytic anaemia.

• Guillain-Barré syndrome.

• Neurological complications such as encephalitis.