Hi, this is Tom and in this episode I'm going to be going through infectious mononucleosis.

And you can find notes at 0.0.5.com and in the 0 to Finals Pediatrics book.

And you can find flashcards and questions at members.02finals.com.

So let's jump straight in.

Infectious mononucleosis is a condition caused by infection with the Epstein-Barr virus, or EBV.

The virus is found in the saliva of infected individuals, and infection may be spread by kissing or sharing cups,

cutlery, toothbrushes or anything contaminated with saliva. It's commonly known as the kissing disease, glandular fever, or simply mono. EBV can be shed in saliva before symptoms develop for months after the infection and intermittently

later in life.

Most people are infected with EBV as children when it causes minimal symptoms and then

they're immune.

When infection occurs in teenagers or young adults, it causes more typical symptoms of infectious mononucleosis.

Let's talk about the presentation.

The typical presentation is an adolescent or a young adult with an acute illness featuring a low-grade fever,

sore throat, fatigue, bilateral posterior cervical lymphadenopathy, which refers to swollen lymph nodes

in the posterior triangle of the neck,

tonsular enlargement with whitewash exudate with a white coating of the tonsils,

which may be confused with acute tonsillitis,

and spleenomegaly, and there's a risk of splenic rupture with a ruptured spleen.

Attempt it for you, infectious mononucleosis can characteristically cause an itchy macular-papular rash in response to amoxicillin.

Look out for the exam question that describes an adolescent with a sore throat who develops an itchy rash after taking amoxicillin.

Let's talk about testing.

The first line tests that are recommended in the nice clinical knowledge summaries updated in November 2024 are a full blood count with a differential white cell count and heterophile antibody test or monospot test in the second week of illness. The heterophile antibody test involves mixing

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