An 18-year-old student presents with a five-day history of fevers, headaches, sore throat, malaise, and mild arthralgia of the hands and elbow joints.

Subject
Medicine
System
Infectious Diseases

Kathryn

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Jul 29, 2020
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An 18-year-old student presents with a five-day history of fevers, headaches, sore throat, malaise, and mild arthralgia of the hands and elbow joints. On examination, her temperature is 37.7°C, there is ulcerative pharyngitis, a fine maculopapular rash, generalised lymphadenopathy and a palpable tender spleen. Investigations show the following results.
White cell count *16.0x10/L (4.0–11.0)
Neutrophils *11.0x10/L (2.0-7.5)
Lymphocytes *4.5x10/L (1.5–4.0)
The blood film show atypical lymphocytes. Monospot (Paul-Bunnell) test is negative.
Which one of the following is the most likely diagnosis?

(A) Streptococcal infection
(B) Measles
(C) Rubella
(D) Herpes simplex infection
(E) Infectious mononucleosis
 
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