HSM LYMPHADENOPATHY

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What is imn?

Infectious mononucleosis is the best-known clinical syndrome caused by Epstein-Barr virus (EBV). It is characterized by systemic somatic complaints consisting primarily of fatigue, malaise, fever, sore throat, and generalized lymphadenopathy

What are the clinical manifestations?

T he incubation period of infectious mononucleosis in adolescents is 30-50 days. In children, it may be shorter. The majority of cases of primary EBV infection in infants and young children are clinically silent.

In older patients, the onset of illness is usually insidious and vague. Patients may complain of malaise, fatigue, acute or prolonged (>1 wk) fever, headache, sore throat, nausea, abdominal pain, and myalgia.

This prodromal period may last 1-2 wk. The complaints of sore throat and fever gradually increase until patients seek medical care. Splenic enlargement may be rapid enough to cause left upper quadrant abdominal discomfort and tenderness, which may be the presenting complaint.

T he classic physical examination findings are generalized lymphadenopathy (90% of cases), splenomegaly (50% of cases), and hepatomegaly (10% of cases). Lymphadenopathy occurs most commonly in the anterior and posterior cervical nodes and the submandibular lymph nodes and less commonly in the axillary and inguinal lymph nodes.

Epitrochlear lymphadenopathy is particularly suggestive of infectious mononucleosis.

DIAGNOSIS

A presumptive diagnosis of infectious mononucleosis may be made by the presence of classical clinical symptoms with atypical lymphocytosis in the peripheral blood. The diagnosis is usually confirmed by serologic testing, either for heterophile antibody or specific EBV antibodies.

The detection of IgM antibody to VCA is the most valuable and specific serologic test for the diagnosis of acute EBV infection and is generally sufficient to confirm the diagnosis.

What is hiv?

About Dr. Jayaprakash

Asst. Prof. of Pediatrics, ICH. Institute of Child Health. Gov. Medical College Kottayam. Kerala, India.

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