Infection · UKMLA & AKT
Epstein-Barr virus (EBV) infectious mononucleosis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise epstein-barr virus (ebv) infectious mononucleosis — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Classic triad: fever, exudative pharyngitis/tonsillitis, cervical lymphadenopathy (classically posterior chain)
- Palatal petechiae - at hard/soft palate junction; highly suggestive of EBV IM
- Splenomegaly - up to 50-75% of cases; peaks second week; creates rupture risk
- Fatigue - profound; can persist weeks to months
- Maculopapular rash - occurs in ~5-15% spontaneously; rises to >90% if amoxicillin or ampicillin given
The amoxicillin/ampicillin rash in EBV is NOT a true penicillin allergy - it is immune complex-mediated in the context of EBV B cell activation. Do NOT document as penicillin allergy; do NOT avoid penicillins in future.
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