Which of the following is FALSE about Infectious mononucleosis
Atypical lymphocytosis -points diagnosis towards Infectious mononucleosis (EBV) (kissing disease) among the given other options. Essentials of Diagnosis Malaise, fever, and (exudative) sore throat Palatal petechiae, lymphadenopathy, splenomegaly, and, occasionally, a maculopapular rash Positive heterophile agglutination test (Monospot) Atypical large lymphocytes in blood smear; lymphocytosis Complications:hepatitis, myocarditis, neuropathy, encephalitis, airway obstruction from adenitis, hemolytic anemia, thrombocytopenia General Consideration EBV is ubiquitous; infects > 95% of the adult population worldwide and persists for the person's lifetime Infectious mononucleosis is a common manifestation of EBV and may occur at any age EBV is largely transmitted by saliva but can also be recovered from genital secretions Saliva may remain infectious during convalescence, for 6 months or longer after symptom onset The incubation period lasts several weeks (30-50 days) In the United States the incidence of EBV infection is declining although prevalence of EBV remains high for those aged 12-19 years Clinical Findings Symptoms and Signs Fever, sore throat, fatigue, malaise, anorexia, and myalgia typically occur in the early phase of the illness Physical findings include Lymphadenopathy (discrete, nonsuppurative, slightly painful, especially along the posterior cervical chain) Transient bilateral upper lid edema (Hoagland sign) Splenomegaly (in up to 50% of patients and sometimes massive) Conjunctival hemorrhage, exudative pharyngitis, uvular edema, tonsillitis, or gingivitis may occur Soft palatal petechiae may be noted Other manifestations Hepatitis Interstitial pneumonitis (sometimes with pleural involvement) Cholestasis Gastritis Kidney disease (mostly interstitial nephritis) Epiglottitis Nervous system involvement (in 1-5%)
Non-Suppurative, painless Lymphadenopathy
Maculo-papular rash or petechial rash
Lymphocytosis is usually demonstrable, with >10% atypical lymphocytes
Transient bilateral upper lid Edema
Bacterial infection