Mononucleosis physical examination

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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

Occasionally, patients infected with EBV may also display splenomegaly, with subsequent life-threatening complication of spleenic rupture and/or hepatomegaly.

Supra-orbital oedema: the eyes become puffy and swollen—may occur in the early stages of infection

White patches on the tonsils and back of the throat are often seen
Tender and enlarged/swollen lymph nodes—particularly the posterior cervical lymph nodes, on both sides of the neck.

Splenomegaly. Rupture may occur without trauma, but impact to the spleen is also a factor.
Hepatomegaly: other complications include hepatitis causing elevation of serum bilirubin (in approximately 40% of patients), jaundice (approximately 5% of cases), and anemia (a deficiency of red blood cells). In rare cases, death may result from severe hepatitis or splenic rupture.