From the Research
Yes, infectious mononucleosis can cause tonsillar exudates. Infectious mononucleosis, commonly known as "mono" and primarily caused by the Epstein-Barr virus (EBV), typically presents with a triad of symptoms including sore throat, fever, and lymphadenopathy. The sore throat is often severe and accompanied by tonsillar enlargement with white or gray-yellow exudates covering the tonsils. These exudates are collections of white blood cells responding to the viral infection and can appear similar to those seen in streptococcal pharyngitis, making clinical differentiation challenging. The tonsillar exudates in mono typically develop within the first week of illness and may persist for 1-3 weeks. This finding occurs because EBV infects B lymphocytes in the oropharyngeal tissue, triggering an intense immune response that manifests as inflammation and exudate formation. According to the most recent study 1, infectious mononucleosis is characterized by a triad of fever, tonsillar pharyngitis, and lymphadenopathy, which supports the presence of tonsillar exudates in patients with infectious mononucleosis. Patients with suspected mono who have tonsillar exudates should be evaluated to rule out streptococcal infection, as both conditions can coexist, and streptococcal pharyngitis requires antibiotic treatment while mono is managed with supportive care. It is essential to note that the diagnosis of infectious mononucleosis is typically made based on clinical presentation and laboratory tests, including the monospot test and serologic testing for antibodies to viral capsid antigens 2. In terms of management, treatment is mainly supportive, with reduction of activity and bed rest as tolerated, and patients should be advised to avoid contact sports or strenuous exercise for 8 weeks or while splenomegaly is still present 1. Overall, the presence of tonsillar exudates in patients with infectious mononucleosis is a common finding and should be considered in the diagnosis and management of the disease. Key points to consider in the management of infectious mononucleosis include:
- Clinical presentation: sore throat, fever, and lymphadenopathy
- Laboratory tests: monospot test and serologic testing for antibodies to viral capsid antigens
- Management: supportive care, reduction of activity, and avoidance of contact sports or strenuous exercise
- Complications: splenic rupture, chronic fatigue syndrome, and increased risk of certain cancers and autoimmune diseases.