Infectious Mononucleosis

Question 1

What are the causes of infectious mononucleosis?

Answer 1

90% of cases are caused by Epstein Barr Virus (herpes virus 4).
Less frequent causes are CMV or Herpes virus 6

Question 2

What are the symptoms of infectious mononucleosis?

Answer 2

Sore throat,
Lymphadenopathy in both anterior and posterior neck chains (tosillitis is only anterior)
Pyrexia
Palatal petechiae,
Splenomegaly,
Hepatitis,
Lymphocytosis
Haemolytic anaemia

Question 3

What are the investigations for infectious mononucleosis?

Answer 3

Heterophile antibody test (monospot)
FBC and LFTs
HIV test

Question 4

What is the management of EBV?

Answer 4

Rest, fluids, analgesia
Avoid contact sport for 4 weeks minimum to avoid splenic rupture
If upper airway compromise then give corticosteroids

Question 5

What are the differential diagnoses for infectious mono?

Answer 5

• Group A strep
• Hepatitis A,
• Acute HIV

Question 6

What are the potential complications of Infectious mono?

Answer 6

• Splenic rupture,
• Neurological complications: Encephalitis, aseptic meningitis, guillian-barre syndrome, cranial nerve palsy,
• Chronic EBV,
• Autoimmune disease eg, MS
• Malignancy,
• acute acalculous cholecystitis,
• Haemophagocytic lymphohistiocytosis (HLH),
• Renal complications,
• Chronic fatigue and depression