Mono


  • Epstein-Barr virus (EBV) is the most common causative agent of IM and is transmitted via contact with oropharyngeal secretions. The diagnostic test of choice in confirming EBV IM is the heterophile antibody test, which screens for IgM antibodies called heterophile antibodies. These antibodies are produced in response to EBV infection and agglutinate with erythrocytes from unrelated species (eg, horse erythrocytes in the Monospot test, sheep erythrocytes in the classic Paul-Bunnell test). Atypical lymphocytes are often seen on peripheral blood smears but are not specific for IM.
  • Corticosteroids are warranted in the treatment of infectious mononucleosis (IM) in rare cases when airway obstruction appears imminent; common warning signs include shortness of breath while recumbent, tachypnea, and inability to swallow. Corticosteroids may also be considered in patients with IM who are immunocompromised or are experiencing other serious complications (eg, aplastic anemia, overwhelming infection, thrombocytopenia).