Mononucleosis physical examination

Mononucleosis Microchapters
Home
Patient Information
Overview
Pathophysiology
Epidemiology and Demographics
Risk Factors
Causes
Differentiating Mononucleosis from other Diseases
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Mononucleosis physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Mononucleosis physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Mononucleosis physical examination
CDC on Mononucleosis physical examination
Mononucleosis physical examination in the news
Blogs on Mononucleosis physical examination
Directions to Hospitals Treating Mononucleosis
Risk calculators and risk factors for Mononucleosis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

The classic initial presentation of mononucleosis include: fever, lymphadenoapthy, pharynigitis, 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

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:

• Peri-orbital oedema may be observed in 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

Atypical rare presentations

Neurological involvement:

• Encephalitis,
• Aseptic meningitis
• Transverse myelitis
• Bell's palsy
• Guillain-Barré syndrome

Cardiac involvement:

• Myocarditis

Abdominal involvement:

• Pancreatitis,
• Acalculous cholecystitis,
• Mesenteric adenitis,
• Glomerulonephritis

References

Template:WikiDoc Sources