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 hepatitis
lymphocytic leukemia
infectious mononucleosis
Hodgkin disease
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.
Infection