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Infectious Mononucleosis

  1. Etiology: Epstein–Barr virus organism can be isolated from:
    1. Blood
    2. Lymph node
    3. Saliva
  2. Age group: Young adults
  3. Clinical Features:
    1. Incubation period : 5-7 wks
    2. Prodromal phase: 4-5 days
    3. Most common manifestation: Tender enlargement of cervical lymph nodes
    4. Sore throat
    5. Fever (in severe form)
    6. Splenomegaly (50%)
    7. Hepatomegaly (10%): Abnormal liver function test: 10%
    8. Rubelliform rashes: sometimes if ampicillin given
    9. A small proportion: Periorbital odema
    10. Other rare manifestations
      i. Facial palsy                                    
      ii. Guillain Barré syndrome
      iii. Meningoencephalitis  
      iv. Myelitis
      v. Myocarditis                                    
      vi. Nephritis                                              
      vii. Pericarditis                                    
      viii. Pneumonia
  1. Blood Picture:
    1. W.B.C. remain normal in the 1st wk and rises in the second week (50%: Mononuclear) (1%: atypical)
    2. Paul-Bunnell & monospot test:
    3. Positive in 90% of the test in the 1st week
    4. Occasionally the patient may have hemolytic anemia, aplastic anemia or thrombocytopenia
  2. Treatment:
    1. Supportive
    2. Steroids if required
    3. Rest
    4. Antibiotics lor secondary infections

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