UMEM Educational Pearls

Category: Pediatrics

Title: Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM)

Keywords: Epstien Barr Virus, Mononucleosis (PubMed Search)

Posted: 2/6/2009 by Rose Chasm, MD (Updated: 4/19/2024)
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Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM) 

Most commonly presenting clinical findings: fever, fatigue, exudative pharyngitis, lymphadenopathy, and hepatosplenomegaly. 

Self-limited illness that lasts an average of 2 - 3 weeks. 

Treatment is primarily supportive.  Use of ampicillin, amoxicillin, or penicillin during the acute phase not indicated and may result in the development of a morbilliform rash, which studies have suggested may occur in more than 50% of the cases.  Antiviral therapy is not recommended. Splenic rupture occurs in about 1 - 2:1000 cases.  Therefore, avoidance of activities that increase the risk for injury is recommended until splenomegaly has resolved. 

References

Hickey SM, Strasburger VC.  What every pediatrician should know about infectious mononucleosis in adloscents.  Pediatr Clin North Am. 1997;44:1541-1556. 

Katz BZ.  Epstein-Barr virus.  In:  Long SS, Pickering LK, Prober CG, eds. York, NY:  Churchill Livingstone; 2—3:1059-1068 

Peter J, Ray CG.  Infectious mononucleosis.  Pediatr Rev.  1998; 19:276-279.