Mononucleosis differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
* | *Acute mononucleosis, [[Cytomegalovirus|acute cytomegalovirus infection]] and [[Toxoplasmosis|toxoplasma gondii infection]] have similar clinical presentations. | ||
:*In addition, since their management is much the same, it is not always helpful, or possible, to distinguish between [[EBV|infectious mononucleosis]] and [[cytomegalovirus|cytomegalovirus infection]]. | |||
:*However, in pregnant women, it is imperative to differentiation mononucleosis from [[toxoplasmosis]] as ''toxo'' is associated with significant consequences for the fetus. | |||
*Acute [[HIV|HIV infection]] can mimic signs similar to those of infectious mononucleosis, and tests should be performed | *Acute [[HIV|HIV infection]] can also mimic signs similar to those of infectious mononucleosis, and tests should be performed in pregnant women for the same reason as [[toxoplasmosis]].<ref name="pmid15508538">{{cite journal |author=Ebell MH |title=Epstein-Barr virus infectious mononucleosis |journal=[[American Family Physician]] |volume=70 |issue=7 |pages=1279–87 |year=2004 |month=October |pmid=15508538 |doi= |url=http://www.aafp.org/link_out?pmid=15508538 |accessdate=2012-02-23}}</ref> | ||
*Other conditions from | *Other conditions to be differentiated from infectious mononucleosis include: | ||
:*[[Leukemia]], | |||
:*[[Tonsillitis]], | |||
:*[[Pharyngitis]], | |||
:*[[Diphtheria]], | |||
:*[[Common cold]], | |||
:*[[adenovirus|Adenovirus infections]] | |||
:*[[Influenza]] | |||
== | ==Differentiating mononucleosis from other causes with similar presentation== | ||
* | ====Pharyngitis==== | ||
*[[EBV|EBV infection]] may cause either exudative or non-exudative pharyngitis and both of which is colonized by [[streptococcus pyogens]] present in the oropharynx | |||
*[[Petechiae|Petechial hemorrhages]] present in the posterior oropharynx are characteristic of infectious mononucleosis | |||
*[[ | |||
*[[Edema|Edema of the uvula]] is rare but if present differentiates mononucleosis from all other types of pharyngitis | |||
====CMV vs. EBV==== | |||
*Although all cases of mononucleosis are caused by the [[EBV]], [[cytomegalovirus]] can produce a similar illness, usually with less [[throat pain]]. | |||
*[[fatigue|Extreme fatigue]], [[edema| bilateral supra-orbital edema]], [[splenomegaly]], elevated liver function tests are characteristic of mononucleosis and may or may not be present in [[cytomegalovirus|cytomegalovirus infections]]. | |||
*Due to the presence of the [[lymphocytes|atypical lymphocytes]] on the blood smear in both conditions, some physicians confusingly used to include both infections under the diagnosis of "mononucleosis," though [[EBV]] is by definition the infection that must be present for this illness. | |||
*An elevated antibody ([[IgM]]) titer specific for [[CMV]] helps to differentiate it from [[EBV|EBV infection]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 21:42, 3 March 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
- Acute mononucleosis, acute cytomegalovirus infection and toxoplasma gondii infection have similar clinical presentations.
- In addition, since their management is much the same, it is not always helpful, or possible, to distinguish between infectious mononucleosis and cytomegalovirus infection.
- However, in pregnant women, it is imperative to differentiation mononucleosis from toxoplasmosis as toxo is associated with significant consequences for the fetus.
- Acute HIV infection can also mimic signs similar to those of infectious mononucleosis, and tests should be performed in pregnant women for the same reason as toxoplasmosis.[1]
- Other conditions to be differentiated from infectious mononucleosis include:
Differentiating mononucleosis from other causes with similar presentation
Pharyngitis
- EBV infection may cause either exudative or non-exudative pharyngitis and both of which is colonized by streptococcus pyogens present in the oropharynx
- Petechial hemorrhages present in the posterior oropharynx are characteristic of infectious mononucleosis
- Edema of the uvula is rare but if present differentiates mononucleosis from all other types of pharyngitis
CMV vs. EBV
- Although all cases of mononucleosis are caused by the EBV, cytomegalovirus can produce a similar illness, usually with less throat pain.
- Extreme fatigue, bilateral supra-orbital edema, splenomegaly, elevated liver function tests are characteristic of mononucleosis and may or may not be present in cytomegalovirus infections.
- Due to the presence of the atypical lymphocytes on the blood smear in both conditions, some physicians confusingly used to include both infections under the diagnosis of "mononucleosis," though EBV is by definition the infection that must be present for this illness.
- An elevated antibody (IgM) titer specific for CMV helps to differentiate it from EBV infection
References
- ↑ Ebell MH (2004). "Epstein-Barr virus infectious mononucleosis". American Family Physician. 70 (7): 1279–87. PMID 15508538. Retrieved 2012-02-23. Unknown parameter
|month=ignored (help)