Infectious Mononucleosis

• Pathogen: Epstein-Barr virus (oral contact)

• SSx: high grade fever, lymphadenopathy (posterior triangle), general malaise, fibrinous exudative tonsillitis, associated hepatosplenomegaly, rhinopharyngitis

• Dx: clinical history, monospot test, Paul-Bunnel test (heterophil antibodies in serum), 80-90% mononuclear and 10% atypical lymphocytes on smear, viral culture

• Complications: acute airway obstruction, cranial nerve involvement, meningitis, autoimmune hemolytic anemia, splenic rupture

• Rx: secure airway for acute obstruction with a nasal trumpet or endotracheal intubation (corticosteroids for severe obstructing tonsillitis), hydration, analgesics, oral hygiene, antimicrobials for secondary infections (ampicillin may cause a severe rash), typically resolves after 2—6 weeks

Diphtheria (see pp. 102-103)

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