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Infectious Mononucleosis — RACP Paediatrics MCQ

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ModerateInfectious DiseaseInfectious MononucleosisRACP Paediatrics

A 12-year-old girl presents with a 1-week history of fatigue, sore throat, and bilateral cervical lymphadenopathy. On examination, she has pharyngeal exudate and moderate splenomegaly. A monospot test is positive. Her ALT is mildly elevated. Which advice is most important?

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Correct answer: D — Avoid contact sports for at least 3 weeks due to risk of splenic rupture

Infectious mononucleosis (EBV) with splenomegaly carries a risk of splenic rupture. Contact sports and vigorous physical activity should be avoided for at least 3 weeks (and until splenomegaly resolves). Amoxicillin should be avoided as it commonly causes a florid maculopapular rash in EBV infection. Mild transaminitis is common and self-resolving.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Infectious Mononucleosis