A patient presents with fever, cervical lymphadenopathy, malaise, abdominal pain and hepatosplenomegaly. This constellation is most typical of infection with which virus?

• A. Epstein-Barr virus
• B. Cytomegalovirus
• C. Human immunodeficiency virus
• D. Adenovirus

Answer: (A)

Infectious mononucleosis caused by Epstein-Barr virus typically presents with fever, swollen cervical lymph nodes, and a general sense of malaise. The abdominal pain along with hepatosplenomegaly reflects liver and especially splenic involvement, which is a common feature in EBV mono. The virus infects B lymphocytes and drives a strong immune response, leading to the prominent lymphadenopathy and systemic symptoms seen in this pattern. Transmission is usually through saliva, and it often affects teenagers and young adults.

Cytomegalovirus can mimic mono but usually has less prominent neck lymphadenopathy and a different pattern of organ involvement. HIV can cause fever and hepatosplenomegaly but the classic mono-like presentation with pronounced cervical lymphadenopathy is more characteristic of EBV. Adenovirus tends to cause respiratory symptoms with fever and does not typically present with the same degree of cervical lymph node enlargement and splenic involvement.