• 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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