Infectious Disease Mononucleosis Case Study

At present, the symptoms presented by the student are consistent with infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV).  This includes symptoms that appear to mimic those of the flu.  In addition to a sore throat, the patient complains of aching joints and fatigue.  It should be noted that an elevated temperature and swollen lymph nodes were revealed following an initial examination by the FNP.  The lab results were, however, unremarkable and a Monospot test turned out to be negative.  It is important to note that “because peak heterophile antibody levels are seen between 2 to 6 weeks from infection, testing too early in the disease process may lead to increased rates of false negative testing” (Stuempfig and Seroy, 2019).  In the case study, we are told that the patient in question has been having “flu-like” symptoms for the last one week.  Therefore, the Monospot test in this case could have been undertaken too early – hence the negative result.  

Infectious mononucleosis is, according to Dunmire, Hugguist, Balfour (2015), characterized by sore throat, cervical lymph node enlargement, fatigue and fever” (219).  As the authors further point out, in as far as lymph node enlargement is concerned, there is often the equal enlargement of anterior and posterior cervical nodes.  Age is also an important consideration on this front.  To a large extent, although one could get IM at any age, it has a higher rate of occurrence amongst teenagers.  IM has been variously referred to as the ‘kissing disease’ owing to the fact that one key mode of transmission of the virus is saliva.  According to Balfour, Dunmire, and Hogguist (2015), the Epstein-Barr Virus is often responsible for the vast majority of all infectious mononucleosis cases.  It therefore follows that in the present case, on the basis of the discussion and findings above, the expected diagnosis would be infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV).  This would be the basis for the patient’s clinical course as well as treatment options.  

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…see to it that the patient is aware of effective strategies and approaches to protect himself from future EBV infection.  On this front, I would advise that he avoids the sharing of personal items such as a toothbrush.  Having a single intimate partner would also minimize the risk of contracting IM via kissing or sexual intercourse.  

It should be noted that as I have pointed out elsewhere in this text, in most cases, IM is not serious and resolves in a month or two.  However, in some rare instances, complications do occur.  In the words of Balfour, Dunmire, and Hogguist (2015), “splenic rupture occurs in