Infectious mononucleosis

Medicine > Infection

Background knowledge 🧠

Definition

Infectious mononucleosis is a clinical syndrome typically caused by the **Epstein-Barr virus (EBV)**, characterised by fever, pharyngitis, lymphadenopathy, and fatigue.
Often referred to as ‘mono’ or ‘glandular fever’.

Epidemiology

Most commonly affects adolescents and young adults.

Aetiology

Primarily due to **EBV**, a member of the herpesvirus family.
Transmission typically through saliva (“kissing disease”).
Less common causes include cytomegalovirus (CMV) and other agents.

Clinical Features 🌡️

Clinical Features

Triad: Fever, pharyngitis (sore throat), and cervical lymphadenopathy.
Fatigue and malaise, which can persist for weeks to months.
Possible splenomegaly and hepatomegaly.
Rash, especially if given ampicillin or amoxicillin.

Investigations 🧪

Tests

Monospot test (heterophile antibody test): Diagnostic in majority but not 100% specific or sensitive.
EBV-specific serology for uncertain cases.
Full blood count: Atypical lymphocytes, lymphocytosis.
Liver function tests: Raised alanine transaminase (ALT) and aspartate transaminase (AST).

Management 🥼

Management

Primarily supportive care: Rest, hydration, analgesia (paracetamol or ibuprofen).
Avoid contact sports due to risk of splenic rupture.
Avoid ampicillin or amoxicillin to prevent rash.
Corticosteroids may be considered in severe cases, airway obstruction, or haemolytic anaemia, but routine use is controversial.

Complications

Splenic rupture (though rare).
Neurological complications: Meningitis, encephalitis, Guillain-Barré syndrome.
Hepatitis, jaundice.
Secondary bacterial pharyngitis or tonsillitis.

Key Points

EBV is the most common cause of infectious mononucleosis.
Diagnosis primarily clinical but supported by Monospot and serology.
Management is mainly supportive; be cautious of splenic rupture in physical activity.

No comments yet 😉

Leave a Reply Cancel reply

You must be logged in to post a comment.

Don't take our word for it

"The stations you provide are strikingly similar to those I came across during my medical school finals (some even verbatim!), and I have tried many other exam platforms. I'm truly grateful for your priceless support throughout my final couple of years at medical school!"

Raza Q 🇬🇧

"It has absolutely everything for medical school, so many histories with detailed differential diagnoses, how to approach emergencies, commonly prescribed drugs..every kind go examination you’ll ever need in osces"

John R 🇬🇧

"Thank you SO MUCH for the amazing educational resource. I’ve tried lots of platforms and books with mock OSCE stations and yours is by far and away the best I’ve tried"

Ed M 🇳🇿

"Get this right away. So helpful for OSCEs but also general clinical learning and understanding. Wish I had brought it sooner"

Emma W 🇬🇧

"Without a doubt, your platform outshines all other OSCE resources currently available. In all honesty, I can confidently attribute my success in securing a distinction in my finals to OSCEstop."

Harish K 🇬🇧

"OSCEstop distinguishes itself from many other platform banks by offering a wealth of questions that mimic the demanding and complex aspects of our finals. This platform played a crucial role in ensuring I was ready for the level of difficulty that awaited me in my final exams."

Natasha W 🇳🇿

😃 More:

📖 Learning notes: 247

🏥 Stations available: 207

🧠 Qbank questions: 2255