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Last Updated: 2/7/2012  

Infectious Mononucleosis

Diagnosis
  • Ask about fatigue, sore throat, fever, abdominal discomfort, lymphadenopathy in neck, and headache or stiff neck.

  • Look for fever, pharyngitis, tonsillar swelling and exudate, bilateral cervical lymphadenopathy, splenomegaly, and hepatic tenderness.

  • Look for acute primary EBV infection presenting in atypical ways in patients over 40 years, such as hepatitis and prolonged fever.

  • Obtain a CBC with differential and look for atypical lymphocytes.

  • Obtain a monospot test.

  • Obtain EBV serologic tests if the monospot test result is negative or if the diagnosis is uncertain.

Therapy
  • Maintain hydration orally or parenterally in those who are unable to drink.

  • Use corticosteroids if there is airway obstruction, especially in pediatric patients.

  • Do not routinely prescribe antiviral drugs for treatment of infectious mononucleosis.

DOI: 10.7326/d924
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Joseph S. Pagano, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Alyssa Harrison, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. A. Martin Lerner, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
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