Differentials
Infectious mononucleosis
SIGNS / SYMPTOMS
Infectious mononucleosis syndrome is most commonly caused by Epstein-Barr virus (EBV) infection, and is clinically indistinguishable from cytomegalovirus.
INVESTIGATIONS
Heterophile test, EBV serology.
HIV
SIGNS / SYMPTOMS
Acute HIV seroconversion often manifests with a febrile syndrome that may be difficult to distinguish from primary cytomegalovirus disease.
This syndrome may include fever, chills, and generalised lymphadenopathy.
INVESTIGATIONS
HIV serology; HIV RNA level.
Toxoplasmosis
SIGNS / SYMPTOMS
In immunocompetent patients, acute toxoplasmosis may present as a mononucleosis-like syndrome.
INVESTIGATIONS
IgA, IgM, IgG toxoplasma serology.
Other viral illness
SIGNS / SYMPTOMS
Viral infections often present as fever in immunocompromised patients and thus may be indistinguishable from cytomegalovirus.
INVESTIGATIONS
Virus-specific culture and nucleic acid testing.
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