Infectious mononucleosis should be suspected in patients 10 to 30 years of age who present with sore throat and significant fatigue, palatal ...Advertisement<< PreviousarticleNextarticle >>Oct1,2004Issue  Epstein-BarrVirusInfectiousMononucleosis Amorerecentarticleonthistopicisavailable.MARKH.EBELL,M.D,M.S.,Athens,GeorgiaAmFamPhysician. 2004 Oct 1;70(7):1279-1287. PatientInformationHandoutAbstractEtiologyandPathophysiologyDiagnosisTreatmentReferencesArticleSectionsAbstractEtiologyandPathophysiologyDiagnosisTreatmentReferencesInfectiousmononucleosisshouldbesuspectedinpatients10to30yearsofagewhopresentwithsorethroatandsignificantfatigue,palatalpetechiae,posteriorcervicalorauricularadenopathy,markedadenopathy,oringuinaladenopathy.Anatypicallymphocytosisofatleast20percentoratypicallymphocytosisofatleast10percentpluslymphocytosisofatleast50percentstronglysupportsthediagnosis,asdoesapositiveheterophileantibodytest.False-negativeresultsofheterophileantibodytestsarerelativelycommonearlyinthecourseofinfection.Patientswithnegativeresultsmayhaveanotherinfection,suchastoxoplasmosis,streptococcalinfection,cytomegalovirusinfection,oranotherviralinfection.Symptomatictreatment,themainstayofcare,includesadequatehydration,analgesics,antipyretics,andadequaterest.Bedrestshouldnotbeenforced,andthepatient’senergylevelshouldguideactivity.Corticosteroids,acyclovir,andantihistaminesarenotrecommendedforroutinetreatmentofinfectiousmononucleosis,althoughcorticosteroidsmaybenefitpatientswithrespiratorycompromiseorseverepharyngealedema.Patientswithinfectiousmononucleosisshouldbewithdrawnfromcontactorcollisionsportsforatleastfourweeksaftertheonsetofsymptoms.Fatigue,myalgias,andneedforsleepmaypersistforseveralmonthsaftertheacuteinfectionhasresolved.InfectiousmononucleosisisaclinicalsyndromecausedbyEpstein-Barrvirus(EBV)thatisparticularlycommoninadolescentsandchildren.Typicalfeaturesofinfectiousmononucleosisincludefever,pharyngitis,adenopathy,malaise,andanatypicallymphocytosis.Splenomegaly,hepatomeg