Infection · UKMLA & AKT
Epstein-Barr virus (EBV) infectious mononucleosis
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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