This is a peripheral blood smear from an adolescent presenting with malaise, headaches, fever, and sore throat.
Challenge: What do you expect to find on the neck exam?
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I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
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4 comments:
My guess would be: mononucleosis infectiosa (Kissings disease) sore throat, lymphadenopathie (with painful neck swelling)
the blood smear shows "weird" lymphocytes (pfeiffers cells or Virocytes) these a reactive cells with atypical presentation (undifferentiated).
order a Abdominal Ultrasound, give acetaminophen/paracetamol for the pain and a xylocain spray for the soare throat. no contact sports for 4 weeks after infection.
Serologie or the EBV quick test can nail the diagnosis
tender posterior cervical nodes?
those look like Downy cells! :) Posterior cervical lymphadenopathy, probably splenomegally.
yep! thanks for the comments
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Kiss and Tell
The peripheral blood smear shows atypical lymphocytosis. Along with the clinical picture and the patient’s age, infectious mononucleosis is the likely diagnosis. On neck exam, you may expect symmetric posterior cervical lymphadenopathy.
Source: UpToDate.
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