Sore throat

A 1 year old boy presents with a high fever for 3 days. On the day of admission, he developed noisy breathing, while his eyelids appeared swollen. He has also been feeding poorly.

His birth and medical histories are unremarkable. All immunizations (including diphtheria) are up to date.

A urinalysis is found to be normal.

Select Relevant Investigations
FBC & Blood Film

Performed

Hb: 11.8 g/dL
Hct: 33.1%
WBC: 18,900/mm3
N: 33% - Band:1%
L: 41%
Platelets 221,000/mm3
Blood film: A significant number of atypical lymphocytes are seen (21%)
Throat swab for RST + culture

Performed

The rapid step test (RST) is negative.
The culture reports will be available in 3 days.
Monospot test

Performed

The monospot test is negative.
EBV serology

Performed

Serology is positive for viral capsid antigen IgM

Select Relevant Management
Amoxicillin
IV fluids
Steroids
Acyclovir