2. Sore throat
The sore throat, also called pharyngitis, is one of the main symptoms of mononucleosis. The throat inflammation can produce severe pain and difficulty to swallow and, in some cases, this symptom can be confused with the pharyngitis produced by the Streptococcus infection.
The presence of petechiae (red, purple or brown spots on the skin, caused by a minor bleed from broken capillary blood vessels) in the veil of the palate is also very common but not exclusively from EBV infection.
3. Inflamed lymph glands
Although all lymphatic chains can be affected by EBV infection, the mostly affected ganglion groups are the ones located in the armpits, neck, chest, groin and abdomen. This symptom is also caused by the activation of the immune system and its fight against the infection.
The inflamed glands are always bilateral and symmetric. For example, if a patient has a neck ganglion inflamed in the right side, it will also have a ganglion inflamed in the left side too.
If the patient has the posterior cervical ganglia bilaterally inflamed, it is highly suggestive of mononucleosis.
Swelling of certain lymph nodes can last for many weeks, and in extreme cases even years, after the infection is overcome.
It is important to know that, if a patient has these first 3 symptoms (fever, pharyngitis, and inflamed lymph glands), mononucleosis must be differentiated from other diseases that can also cause these symptoms, such as cytomegalovirus (CMV), acute infection by Human Immunodeficiency Virus (HIV), human herpesvirus 6 (HHV-6), hepatitis and toxoplasmosis.
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