Case Scenario: Infectious Mononucleosis
A 21 year old student presents to your clinic with a 1 week history of a sore throat, stiffness and tenderness in his neck, and extreme malaise. On examination, he was mildly pyrexial with posterior cervical lymphadenopathy, palatal petechiae and pharyngeal inflammation without an exudate. Abdominal examination showed mild splenomegaly. There was no evidence of a skin rash or jaundice.
The clinical diagnosis of infectious mononucleosis (‘glandular fever’) was confirmed on investigation. His white cell count was 13 x 109 /L (Normal Range 4-10 x 109 /L) with over 50% of the lymphocytes showing atypical morphology (‘atypical lymphocytosis’). His serum contained IgM antibodies to Epstein-Barr viral capsid antigen (VCA), the most specific test for acute infectious mononucleosis. Liver function tests were normal.
He was treated symptomatically and was advised to avoid sporting activity until his splenomegaly had completely resolved and was recommended to abstain from alcohol for at least 6 months.
Assessment: ESSAY– MEDICAL FORMAT
The essay must discuss the clinical symptoms and pathogenesis of the condition in the context of the information provided in the case study (see case below details). It must also describe in some detail the following processes relating to the condition: • the infection process • the acute inflammatory process and • the potential for chronic inflammation.
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