Infectious Mononucleosis vs Toxoplasmosis
Infectious Mononucleosis and Toxoplasmosis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Infectious Mononucleosis vs Toxoplasmosis at a glance
- Infectious Mononucleosis: Acute viral syndrome caused by Epstein-Barr virus — fever, pharyngitis, posterior cervical lymphadenopathy, fatigue, and atypical lymphocytosis.
- Toxoplasmosis: Obligate intracellular protozoan infection (Toxoplasma gondii) — usually asymptomatic, but causes severe congenital disease and CNS lesions in immunocompromised hosts.
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Side-by-side comparison
| Feature | Infectious Mononucleosis | Toxoplasmosis |
|---|---|---|
| At a glance | Acute viral syndrome caused by Epstein-Barr virus — fever, pharyngitis, posterior cervical lymphadenopathy, fatigue, and atypical lymphocytosis. | Obligate intracellular protozoan infection (Toxoplasma gondii) — usually asymptomatic, but causes severe congenital disease and CNS lesions in immunocompromised hosts. |
| Classic presentation | An adolescent with sore throat, fatigue, posterior cervical adenopathy, and a diffuse maculopapular rash after a course of amoxicillin given for presumed… | AIDS patient with CD4 <100, headache, focal neuro deficit, and multiple ring-enhancing brain lesions on MRI in the basal ganglia or gray-white junction —… |
| Workup / key labs | Clinical syndrome + positive heterophile antibody OR positive EBV VCA IgM with negative EBNA-1 IgG.; CBC with differential: lymphocytic predominance with ≥10%… | Clinical syndrome + serology/PCR + imaging. CNS toxoplasmosis in HIV often diagnosed empirically with response to therapy (2-week trial); biopsy if no… |
| Imaging | Abdominal ultrasound only if splenic enlargement clinically suspected and would change activity counseling (most evidence does not support routine imaging) | MRI brain with contrast: multiple ring-enhancing lesions with surrounding edema, predilection for basal ganglia and gray-white junction; CT (if MRI… |
| First-line treatment | Supportive care: hydration, NSAIDs/acetaminophen, rest, throat lozenges/saltwater gargles; Avoid contact sports/heavy exertion for at least 3 weeks (and until… | Acute acquired in immunocompetent host: typically no treatment unless severe or visceral disease; Ocular toxoplasmosis: pyrimethamine + sulfadiazine +… |
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