Mononucleosis physical examination: Difference between revisions
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The classic initial presentation of mononucleosis include: [[fever]], [[lymphadenopathy]], [[pharyngitis]], [[Petechial|rash]] and/or [[oedema|periorbital oedema]]. Occasionally, patients infected with [[EBV]] may also display [[splenomegaly]], with subsequent life-threatening complication of [[splenic rupture]] and/or [[hepatomegaly]]. | The classic initial presentation of mononucleosis include: [[fever]], [[lymphadenopathy]], [[pharyngitis]], [[Petechial|rash]] and/or [[oedema|periorbital oedema]]. Occasionally, patients infected with [[EBV]] may also display [[splenomegaly]], with subsequent life-threatening complication of [[splenic rupture]] and/or [[hepatomegaly]]. | ||
==Active EBV Infection | ==Physical Examination== | ||
===Active EBV Infection=== | |||
====Vitals==== | ====Vitals==== | ||
*[[Bradycardia]] is a rare and inconsistent finding | *[[Bradycardia]] is a rare and inconsistent finding | ||
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*[[Hepatomegaly]] | *[[Hepatomegaly]] | ||
==Chronic EBV Infection | ===Chronic EBV Infection=== | ||
*The course of the disease can also be chronic presenting with [[chronic fatigue syndrome]] which is a variant of mononucleosis. However, the findings need to be present for months or years to be classified as chronic EBV syndrome or [[chronic fatigue syndrome]]. | *The course of the disease can also be chronic presenting with [[chronic fatigue syndrome]] which is a variant of mononucleosis. However, the findings need to be present for months or years to be classified as chronic EBV syndrome or [[chronic fatigue syndrome]]. | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
Latest revision as of 18:06, 18 September 2017
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Mononucleosis physical examination On the Web |
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Risk calculators and risk factors for Mononucleosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The classic initial presentation of mononucleosis include: fever, lymphadenopathy, pharyngitis, rash and/or periorbital oedema. Occasionally, patients infected with EBV may also display splenomegaly, with subsequent life-threatening complication of splenic rupture and/or hepatomegaly.
Physical Examination
Active EBV Infection
Vitals
- Bradycardia is a rare and inconsistent finding
Skin
- Maculopapular rash which is generalized, non-itchy, faint and disappears rapidly may be observed during the early phase of the disease.
- Jaundice: varies with the age of presentation. Among young adults with mono ~5% of cases present with jaundice; however, among the elderly age group, ~30% present with anicteric viral hepatitis
- Anemia is uncommon, even though EBV infection induces antibodies to RBC-membranes
Eyes
- Hoagland sign: Transient bilateral supra-orbital oedema that is observed during the early stages of infection.
Ear, Nose and Throat
- Tender lymphadenopathy is present; in particular, the posterior cervical lymph nodes on both sides of the neck are involved.
- Pharyngitis secondary to mono may be either be exudative or non-exudative. Either type of pharyngitis is colonized by group A strep.
- White patches may also observed in the tonsils associated with massive tonsilar enlargement which may lead to fatal airway obstruction.
- Petechial hemorrhages may be observed in the posterior oropharynx; particularly involving the palate.
Abdomen
- Tender splenomegaly is a late-feature. Following recovery from initial illness, spleen returns to normal or near normal size.
- Hepatomegaly
Chronic EBV Infection
- The course of the disease can also be chronic presenting with chronic fatigue syndrome which is a variant of mononucleosis. However, the findings need to be present for months or years to be classified as chronic EBV syndrome or chronic fatigue syndrome.
- Physical findings include:
- Significantly lower level of activity in comparison to baseline
- Impaired cognitive dysfunction,
- Tender cervical or axillary lymph nodes
- For more information, click here.