Mononucleosis physical examination: Difference between revisions

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__NOTOC__
{{Mononucleosis}}
{{Mononucleosis}}
{{CMG}}; {{AOEIC}} {{LG}}
{{CMG}}


==Overview==
==Overview==
The classic initial presentation of mononucleosis include: [[fever]], [[lymphadenoapthy]], [[pharynigitis]], [[Petechial|rash]] and/or [[oedema|periorbital oedema]]. Occasionally, patients infected with [[EBV]] may also display [[splenomegaly]], with subsequent life-threatening complication of [[splenic rupture]] and/or [[hepatomegaly]].  
The classic initial presentation of mononucleosis include: [[fever]], [[lymphadenopathy]], [[pharyngitis]], [[Petechial|rash]] and/or [[oedema|periorbital oedema]]. Occasionally, patients infected with [[EBV]] may also display [[splenomegaly]], with subsequent life-threatening complication of [[splenic rupture]] and/or [[hepatomegaly]].


==Active EBV Infection: Physical Examination==  
==Physical Examination==
====Vitals:====
 
===Active EBV Infection===  
====Vitals====
*[[Bradycardia]] is a rare and inconsistent finding
*[[Bradycardia]] is a rare and inconsistent finding


====Skin:====
====Skin====
*[[Rash|Maculopapular rash]] which is generalized, non-itchy, faint and disappears rapidly may be observed during the early phase of the disease.  
*[[Rash|Maculopapular rash]] which is generalized, non-itchy, faint and disappears rapidly may be observed during the early phase of the disease.  


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*[[Anemia]] is uncommon, even though [[EBV|EBV infection]] induces antibodies to RBC-membranes
*[[Anemia]] is uncommon, even though [[EBV|EBV infection]] induces antibodies to RBC-membranes


====Eyes:====
====Eyes====
*'''''Hoagland sign:''''' Transient bilateral [[oedema|supra-orbital oedema]] that is observed during the early stages of infection.
*Hoagland sign: Transient bilateral [[oedema|supra-orbital oedema]] that is observed during the early stages of infection.


====Ear, Nose and Throat:====
====Ear, Nose and Throat====
*[[Lymphadenopathy|Tender lymphadenopathy]] is present; in particular, the posterior [[cervical lymph nodes]] on both sides of the neck are involved.
*[[Lymphadenopathy|Tender lymphadenopathy]] is present; in particular, the posterior [[cervical lymph nodes]] on both sides of the neck are involved.


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*[[Petechial]] [[hemorrhages]] may be observed in the posterior oropharynx; particularly involving the palate.
*[[Petechial]] [[hemorrhages]] may be observed in the posterior oropharynx; particularly involving the palate.


====Abdomen:====
====Abdomen====
*[[Splenomegaly|Tender splenomegaly]] is a late-feature. Following recovery from initial illness, spleen returns to normal or near normal size.
*[[Splenomegaly|Tender splenomegaly]] is a late-feature. Following recovery from initial illness, spleen returns to normal or near normal size.
*[[Hepatomegaly]]  
*[[Hepatomegaly]]  


==Chronic EBV Infection: Physical Examination==
===Chronic EBV Infection===
*The course of the disease can also be chronic presenting with [[chronic fatigue syndrome]] which is a variant of mononucleosis. However, the findings need to be present for '''''months or years''''' to be classified as chronic EBV syndrome or [[chronic fatigue syndrome]].
*The course of the disease can also be chronic presenting with [[chronic fatigue syndrome]] which is a variant of mononucleosis. However, the findings need to be present for months or years to be classified as chronic EBV syndrome or [[chronic fatigue syndrome]].


*Physical findings include:
*Physical findings include:
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
 
[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Medicine]]
[[Category:Otolaryngology]]
[[Category:Lymphocytes]]
[[Category:Viral diseases]]

Latest revision as of 18:06, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The classic initial presentation of mononucleosis include: fever, lymphadenopathy, pharyngitis, rash and/or periorbital oedema. Occasionally, patients infected with EBV may also display splenomegaly, with subsequent life-threatening complication of splenic rupture and/or hepatomegaly.

Physical Examination

Active EBV Infection

Vitals

Skin

  • Maculopapular rash which is generalized, non-itchy, faint and disappears rapidly may be observed during the early phase of the disease.
  • Jaundice: varies with the age of presentation. Among young adults with mono ~5% of cases present with jaundice; however, among the elderly age group, ~30% present with anicteric viral hepatitis

Eyes

  • Hoagland sign: Transient bilateral supra-orbital oedema that is observed during the early stages of infection.

Ear, Nose and Throat

  • Pharyngitis secondary to mono may be either be exudative or non-exudative. Either type of pharyngitis is colonized by group A strep.
  • Petechial hemorrhages may be observed in the posterior oropharynx; particularly involving the palate.

Abdomen

Chronic EBV Infection

  • The course of the disease can also be chronic presenting with chronic fatigue syndrome which is a variant of mononucleosis. However, the findings need to be present for months or years to be classified as chronic EBV syndrome or chronic fatigue syndrome.
  • Physical findings include:
  • For more information, click here.

References


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