Epstein-Barr mononucleosis
Epstein-Barr mononucleosis
It must be considered in 15-25 year old patients (peak incidence) with a painful throat that takes about 7 days to reach its peak.
Clinical features
- sore throat
- prodromal fever, malaise, lethargy
- anorexia, myalgia
- nasal quality to voice
- skin rash
Examination
- petechiae on palate (not pathognomonic)
- enlarged tonsils with or without white exudates (looks, but isn’t, purulent)
- periorbital oedema
- lymphadenopathy, especially posterior cervical
- splenomegaly (50%)
- jaundice ± hepatomegaly (5-10%)
The rash
- primary rash (5%)
- secondary rash
- with ampicillin, amoxycillin (90-100%)
- with penicillin (50%)
Diagnosis
- blood film—atypical lymphocytes
- white cell count—absolute lymphocytosis
- heterophil antibodies
or
Monospot test
or
EBV IgM test (more specific)
Complications
Rash
Extreme lethargy
17/05/2023 - New videos added FRACGP study notes section- Rosacea, Rhinophyma)
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