Glandular fever (infectious mononucleosis)

Glandular fever (infectious mononucleosis)

This systemic condition is usually caused by EBV , but similar features can be caused by cytomegalovirus or toxoplasmosis. The tonsils are typically erythematous with a creamy grey exudate and appear almost confluent, usually symmetrical ( Figure 52.30 ). In addition to the discomfort and dysphagia, patients may drool saliva and have respiratory di ffi culty , particularly on inspiration. They commonly have a high temperature and gross general malaise with marked cervical or generalised lymphadenopathy . Occasionally , an enlarged spleen or liver may be detected. The condition is most frequent in teenagers and young adults. The diagnosis can be confirmed by serological testing for EBV , which has now commonly replaced Paul–Bunnell testing, an absolute and relative lymphocytosis, and the presence of atypical monocytes in the peripheral blood. John Rodman Paul , 1893–1971, Professor of Preventative Medicine, Yale University , New Haven, CT , USA. Walls Willard Bunnell , 1902–1966, American physician. Paul and Bunnell described this test in 1932. Moritz Kaposi , 1837–1902, Professor of Dermatology , Vienna, Austria, described pigmented sarcoma of Analgesia and maintenance of fluid intake are important. A small number of patients require admission to hospital if the airway is compromised or if oral intake of fluids is not possible, and a short course of steroids may be helpful. Antibiotics are of little value and ampicillin is contraindicated because of the frequent appearance of a widespread skin rash. Rarely , if the airway is severely compromised, an elective tracheostomy under local anaesthesia is safer and less traumatic than an emergency intubation. Emergency tonsillectomy is contra - indicated because of the generalised pharyngeal oedema and compromised airway . Glandular fever (infectious mononucleosis)

This systemic condition is usually caused by EBV , but similar features can be caused by cytomegalovirus or toxoplasmosis. The tonsils are typically erythematous with a creamy grey exudate and appear almost confluent, usually symmetrical ( Figure 52.30 ). In addition to the discomfort and dysphagia, patients may drool saliva and have respiratory di ffi culty , particularly on inspiration. They commonly have a high temperature and gross general malaise with marked cervical or generalised lymphadenopathy . Occasionally , an enlarged spleen or liver may be detected. The condition is most frequent in teenagers and young adults. The diagnosis can be confirmed by serological testing for EBV , which has now commonly replaced Paul–Bunnell testing, an absolute and relative lymphocytosis, and the presence of atypical monocytes in the peripheral blood. John Rodman Paul , 1893–1971, Professor of Preventative Medicine, Yale University , New Haven, CT , USA. Walls Willard Bunnell , 1902–1966, American physician. Paul and Bunnell described this test in 1932. Moritz Kaposi , 1837–1902, Professor of Dermatology , Vienna, Austria, described pigmented sarcoma of Analgesia and maintenance of fluid intake are important. A small number of patients require admission to hospital if the airway is compromised or if oral intake of fluids is not possible, and a short course of steroids may be helpful. Antibiotics are of little value and ampicillin is contraindicated because of the frequent appearance of a widespread skin rash. Rarely , if the airway is severely compromised, an elective tracheostomy under local anaesthesia is safer and less traumatic than an emergency intubation. Emergency tonsillectomy is contra - indicated because of the generalised pharyngeal oedema and compromised airway .