Mononucleosis differential diagnosis
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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
- Diagnosis of acute infectious mononucleosis should also take into consideration acute cytomegalovirus infection and toxoplasma gondii infections. These diseases are clinically very similar by their signs and symptoms. Because their management is much the same, it is not always helpful, or possible, to distinguish between EBV mononucleosis and cytomegalovirus infection. However, in pregnant women, differentiation of mononucleosis from toxoplasmosis is associated with significant consequences for the fetus.
- Acute HIV infection can mimic signs similar to those of infectious mononucleosis, and tests should be performed for pregnant women for the same reason as toxoplasmosis.[1]
- Other conditions from which to distinguish infectious mononucleosis include leukemia, tonsillitis, diphtheria, common cold and influenza.
Other diseases with similar presentation
- Although all cases of mononucleosis are caused by the EBV, cytomegalovirus can produce a similar illness, usually with less throat pain. 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.
- Symptoms similar to those of mononucleosis can be caused by adenovirus, acute HIV infection and the protozoan Toxoplasma gondii.
Diseases associated with EBV
- Infectious mononucleosis
- Stevens-Johnson syndrome
- Hepatitis
- Herpes
- Alice in Wonderland syndrome
- Several Non-Hodgkin's lymphomas, including primary cerebral lymphoma
- Hodgkin's disease
- Post-transplant lymphoproliferative disorder
- Herpangina
- Multiple Sclerosis (higher risk in patients infected as teenagers than as children)
- Hairy leukoplakia
- Common variable immunodeficiency (CVID)
- Kikuchi's disease
- Nasopharyngeal cancer
- Subepithelial Infiltrates
- Smooth muscle tumors [2]
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) - ↑ Deyrup AT, Lee VK, Hill CE, Cheuk W, Toh HC, Kesavan S, Chan EW, Weiss SW. "Epstein-Barr virus-associated smooth muscle tumors are distinctive mesenchymal tumors reflecting multiple infection events: a clinicopathologic and molecular analysis of 29 tumors from 19 patients". Am J Surg Pathol. 2006 Jan;30(1):75-82. PMID 16330945.