Which signs and symptoms are findings in both cytomegalovirus (CMV) mononucleosis (mono) and Epstein-Barr virus (EBV) infectious mono and how are they distinguished?

Updated: Sep 20, 2018
  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

CMV mononucleosis is the heterophile-negative cause of infectious mononucleosis that is most likely to be confused with EBV infectious mononucleosis. CMV infectious mononucleosis may be indistinguishable in clinical presentation from EBV but is usually not accompanied by posterior cervical adenopathy. Nonexudative pharyngitis is minimal or absent, and splenomegaly is less common than in EBV infectious mononucleosis. CMV infectious mononucleosis is characterized by its prolonged course and prominent liver involvement. Serum transaminases may persistently remain mildly to moderately elevated for prolonged periods. In patients presenting with infectious mononucleosis that has persisted for 6-12 months after a mononucleosislike illness, the condition is most likely due to CMV infectious mononucleosis.


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