Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- fever
- pharyngitis
- cervical or generalised lymphadenopathy
- malaise
Other diagnostic factors
- splenomegaly
- rash
- signs of hepatitis (hepatomegaly, jaundice)
- jaundice
- myalgia
Diagnostic investigations
1st investigations to order
- FBC
- heterophile antibodies
- Epstein-Barr virus (EBV)-specific antibodies
- LFTs
Investigations to consider
- real-time polymerase chain reaction (PCR)
- ultrasonography of abdomen
- CT of abdomen
Treatment algorithm
Contributors
Authors
George Turabelidze, MD, PhD
Medical Epidemiologist
Missouri Department of Health and Senior Services
Adjunct Assistant Professor of Clinical Pediatrics
Washington University School of Medicine
St Louis
MO
Disclosures
GT declares that he has no competing interests.
Peer reviewers
Linda Kalilani, MBBS, MPhil, PhD
Epidemiologist
College of Medicine
University of Malawi
Zomba
Malawi
Disclosures
LK declares that she has no competing interests.
Paul G. Auwaerter, MD, MBA, FACP, FIDSA
Clinical Director
Division of Infectious Diseases
Associate Professor of Medicine
Divisions of Infectious Diseases and General Internal Medicine
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
PGA declares that he has no competing interests.
References
Key articles
Vetsika EK, Callan M. Infectious mononucleosis and Epstein-Barr virus. Expert Rev Mol Med. 2004 Nov 5;6(23):1-16. Abstract
Katz BZ. Update on chronic fatigue syndrome and Epstein-Barr virus. Pediatr Ann. 2002 Nov;31(11):741-4. Abstract
Ganzel TM, Goldman JL, Padhya TA. Otolaryngologic clinical patterns in pediatric infectious mononucleosis. Am J Otolaryngol. 1996 Nov-Dec;17(6):397-400. Abstract
De Paor M, O'Brien K, Fahey T, et al. Antiviral agents for infectious mononucleosis (glandular fever). Cochrane Database Syst Rev. 2016 Dec 8;(12):CD011487.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available here.
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