Infectious Mononucleosis

The diagnosis of infectious mononucleosis can be entertained in those children, adolescents and young adults who present with fever, sore throat, malaise, and fatigue accompanied by tonsillopharyngitis and lymphadenopathy.

There is strong evidence for Epstein-Barr virus (EBV) as the etiologic agent of the "mononucleosis syndrome." The age of initial (primary) infection varies and appears to depend upon socioeconomic status. The mononucleosis symptom complex is associated with the primary infection. A 2- to 5-day prodromal period of malaise and fatigue with or without fever may precede the full onset of the syndrome. The adenopathy is usually confined to the anterior and posterior cervical chain but may be generalized. There is a 5-percent incidence of a generalized erythematous maculopapular rash associated with an enanthem consisting of petechiae on the soft palate. The incidence of the rash increases to almost 100 percent in those patients taking ampicillin or its congeners. The treatment for infectious mononucleosis is supportive.

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