Infectious mononucleosis

Revision as of 18:29, 3 November 2014 by Rossdonaldson1 (talk | contribs)

Background

  • Caused by Epstein-Barr virus
    • CMV and HHV-6 may cause mononucleosis-like illnesses

Clinical Features

  • Triad of:
    • Fever
    • Pharyngitis
    • Lymphadenopathy
  • Symptoms
    • abrupt or insidious, ha, fever & malaise common w/ st & lad to follow
    • Rash in 10-15% usu btwn 4th-6th day of illness
      • red macular or maculopapular morbilliform rash of trunk & upper arms
      • occ involves face, thigh & legs, periorbital & eyelid edema in 50% of cases

Diagnosis

  • Heterophile antibody (monospot) test
    • Up to 25% of pts in 1st week of symptoms may have false negative test
    • 10% of pts w/ EBV infection will be persistently negative
  • Amoxicillin reaction
    • Amoxicillin in pt w/ EBV will cause maculopapular rash in most
  • Definitive testing for suspected Mono during pregnancy (to r/o other pathology)
    • Send for: Epstein Barr virus, cytomegalovirus, and HIV

Differential Diagnosis

Pediatric Rashes

Pediatric Rash

Treatment

  • Supportive

Source

Tintinalli