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Discussion Starter · #1 ·
A 15-year-old boy presents to the physician’s office complaining of fatigue, headache, myalgias, and sore throat that have been continuous for 1.5 weeks. The patient has generalized lymphadenopathy of the cervical, submandibular, and epitrochlear nodes, in addition to splenomegaly. His tonsils are significantly enlarged with exudates. Peripheral blood smear shows 65% lymphocytes, with 15% atypical lymphocytes. Heterophile antibody test is positive.
Which is the most likely cause of his syndrome?
(A) Cytomegalovirus
(B) Epstein-Barr virus
(C) HIV-1
(D) Human herpes virus-6
(E) Infection with Toxoplasma
 

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Discussion Starter · #5 ·
Its EBV

All of the other choices can cause mononucleosis-like syndrome but they will not cause a heterophile positive test. Also, CMV very rarely causes tonsillar exudates or lymphadenopathy.
Epitrochlear LN enlargement is very specific of EBV infection.
 
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