An 18-year-old woman presents to the clinic complaining of malaise for the past 3 weeks, fever for 2 weeks, and a sore throat. Physical examination shows pharyngeal infection with enlarged tonsils and a patchy, white exudate; enlarged, palpable anterior and posterior cervical, axillary, and inguinal lymph nodes; tenderness in the right upper quadrant; and minimal splenomegaly. Laboratory data show hemoglobin 14 g/dL; hematocrit 42%; platelets 380,000/mL; WBC 8500/mL, with 35% segmented neutrophils, 1% eosinophils, and 64% lymphocytes, of which 36% were atypical. Which of the following is the most likely diagnosis?
Infectious mononucleosis is an acute, self-limited infection of the lymphatic system by the EBV Typical infectious mononucleosis has an incubation period of 4-8 weeks. The prodrome includes malaise, anorexia, and chills, and then the classic symptoms of pharyngitis, fever, and lymphadenopathy develop. Headache is also common.
infectious hepatitis
lymphocytic leukemia
infectious mononucleosis
Hodgkin disease
Infection