Challenger Quick Quiz 2012.05.15

A 23-year-old patient with a sore throat is rapidly deteriorating.

A 23-year-old male presents with fever, sore throat and malaise and is diagnosed with infectious mononucleosis. He subsequently returns and requires admission for splenomegaly, hemolytic anemia, thrombocytopenia, aplastic anemia, and significant tonsillar enlargement with airway compromise (see image below). He is ill and obviously deteriorating.

Question:

Which statement correctly describes a treatment option for severe infectious mononucleosis?

a) In patients with severe mononucleosis, valacyclovir therapy decreases the risk of fulminant viremia, splenic rupture, cardiovascular collapse, and death.
b) Corticosteroids may be helpful in the management of the upper-airway obstruction, hemolytic anemia, and thrombocytopenia associated with severe infectious mononucleosis.
c) Acyclovir has been shown to reduce the severity of symptoms and to shorten the hospital stay by 20% in severe mononucleosis cases.
d) Etoposide reduces the incidence of shock in patients with severe infectious mononucleosis.
e) Preliminary studies show that treatment with zanamivir decreases the need for advanced airway management in hospitalized patients with severe mononucleosis.

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