Mononucleosis physical examination: Difference between revisions
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==Active EBV Infection: Physical Examination== | ==Active EBV Infection: Physical Examination== | ||
====Vitals | ====Vitals==== | ||
*[[Bradycardia]] is a rare and inconsistent finding | *[[Bradycardia]] is a rare and inconsistent finding | ||
====Skin | ====Skin==== | ||
*[[Rash|Maculopapular rash]] which is generalized, non-itchy, faint and disappears rapidly may be observed during the early phase of the disease. | *[[Rash|Maculopapular rash]] which is generalized, non-itchy, faint and disappears rapidly may be observed during the early phase of the disease. | ||
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*[[Anemia]] is uncommon, even though [[EBV|EBV infection]] induces antibodies to RBC-membranes | *[[Anemia]] is uncommon, even though [[EBV|EBV infection]] induces antibodies to RBC-membranes | ||
====Eyes | ====Eyes==== | ||
* | *Hoagland sign: Transient bilateral [[oedema|supra-orbital oedema]] that is observed during the early stages of infection. | ||
====Ear, Nose and Throat | ====Ear, Nose and Throat==== | ||
*[[Lymphadenopathy|Tender lymphadenopathy]] is present; in particular, the posterior [[cervical lymph nodes]] on both sides of the neck are involved. | *[[Lymphadenopathy|Tender lymphadenopathy]] is present; in particular, the posterior [[cervical lymph nodes]] on both sides of the neck are involved. | ||
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*[[Petechial]] [[hemorrhages]] may be observed in the posterior oropharynx; particularly involving the palate. | *[[Petechial]] [[hemorrhages]] may be observed in the posterior oropharynx; particularly involving the palate. | ||
====Abdomen | ====Abdomen==== | ||
*[[Splenomegaly|Tender splenomegaly]] is a late-feature. Following recovery from initial illness, spleen returns to normal or near normal size. | *[[Splenomegaly|Tender splenomegaly]] is a late-feature. Following recovery from initial illness, spleen returns to normal or near normal size. | ||
*[[Hepatomegaly]] | *[[Hepatomegaly]] | ||
==Chronic EBV Infection: Physical Examination== | ==Chronic EBV Infection: Physical Examination== | ||
*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 | *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: | *Physical findings include: | ||
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*'''''For more information, click [[Chronic fatigue syndrome physical examination|here]].''''' | *'''''For more information, click [[Chronic fatigue syndrome physical examination|here]].''''' | ||
==Related | ==Related Chapters== | ||
*[[Chronic fatigue syndrome physical examination]] | *[[Chronic fatigue syndrome physical examination]] | ||
Revision as of 00:39, 18 December 2012
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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, 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.
Active EBV Infection: 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
- 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: Physical Examination
- 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.