A 17-year-old girl from southern China has had a sore throat and fever for 1 week. On physical ...

ANS: E. The clinical manifestations described are classic for infectious mononucleosis secondary to Epstein-Barr virus (EBV) infection. These include sore throat, fever, fatigue, and generalized lymphadenopathy. The differential diagnosis for sore throat includes streptococcal infection; however, the rapid strep test for streptococcal infection is negative in this patient. In addition, the peripheral blood smear of patients with mononucleosis often contains abundant numbers of large morphologically atypical lymphocytes. EBV infection is one of the etiologic factors associated with malignant tumors, including nasopharyngeal carcinoma in Chinese populations, Burkitt's lymphoma in equatorial African populations, and other B cell lymphomas in immunosuppressed populations.

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