UMEM Educational Pearls - By Rose Chasm

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: 11/22/2024)
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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.

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Title: Tinea Capitis

Category: Pediatrics

Posted: 3/9/2013 by Rose Chasm, MD (Updated: 11/22/2024)
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Tinea capitis (ringworm of the scalp) is caused by dermatophytic fungi
Trichophyton tonsurans is the most common species in the US, and does NOT flouresce under Wood's lamp
Griseofulvin (20-25mg/kg/ day orally) is the standard first-line therapy in children older than 2 years, and has a good safety profile
Both tablet and suspension formulations are available, and it should be taken with food that are high in fat to increase drug concentrations
NO laboratory assessment of hepatic enzymes is required during the 8-week therapy course in children who have no history or clinical examination findings concerning for liver disease.
Topical antifungal agents are ineffective because they do not penetrate sufficiently into the hair shaft.