Epstein-Barr virus, enveloped DNA virus is transmitted via saliva and infects B lymphocytes, causing proliferation of mononuclear T-cells. Incubation: 4-7 weeks.

 

Fleeting macular rash and facial oedema, pharyngitis, generalised lymphadenopathy 100% of cases (especially posterior cervical chain), hepatosplenomegaly, jaundice (commonest cause of viral hepatitis in UK), petechial rash, rash with amoxicillin (90%).

Childhood infection is usually asymptomatic. In adults fever, malaise, severe sore throat, myalgia, anorexia, abdominal pain, vomiting.

Bloods: FBC (increased WCC, thrombocytopenia), LFTs, 

Microbiology: Positive Monospot / Paul Bunnell test, viral PCR.

Conservative: Supportive

Excellent in infectious mononucleosis.

Lymphocytic meningitis, Guillain-Barré syndrome, autoimmune haemolytic anaemia, splenic rupture, B cell lymphomas if immunocompromised.