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Infectious mononucleosis (IM), caused by the Epstein-Barr virus (EBV), is primarily a self-limiting illness. However, it often mimics bacterial infections, such as bacterial tonsillitis, which can represent a diagnostic pitfall and, consequently, increase the risk of developing complications. The aim of this case report is to highlight the complications resulting from the incorrect differential diagnosis of EBV-induced IM and its clinical significance. We present the case of a 24-year-old male who was initially misdiagnosed with bacterial tonsillitis. Amoxicillin-clavulanic acid was initiated for treatment, after which he developed a widespread maculopapular rash. Acute EBV infection was diagnosed via serological tests. His condition improved following the discontinuation of antibiotic therapy and the administration of supportive symptomatic treatment. This case underscores the critical need for careful differential diagnosis between viral and bacterial tonsillitis. It demonstrates that an amoxicillin-clavulanic acid-induced rash can serve as an important clue for underlying EBV infection, thereby preventing unnecessary antibiotic use and enabling the correct direction of investigation and management.
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http://dx.doi.org/10.7759/cureus.89023 | DOI Listing |
Ren Fail
December 2025
Department of Otolaryngology-Head & Neck Surgery, Asahikawa Medical University, Asahikawa, Japan.
An aberrant mucosal immune response against commensal bacteria in the tonsils is hypothesized to be one of the pathogenic mechanisms underlying immunoglobulin A nephropathy (IgAN). However, the bacteria involved in the pathogenesis of IgAN have not been fully elucidated. In this study, we compared the differences in tonsillar bacterial flora between IgAN ( = 101) and recurrent tonsillitis (RT) ( = 117) based on swab cultures from tonsillar surfaces and the center of the tonsils.
View Article and Find Full Text PDFCureus
July 2025
Infectious Diseases, Globalmed University Clinic, Tbilisi, GEO.
Infectious mononucleosis (IM), caused by the Epstein-Barr virus (EBV), is primarily a self-limiting illness. However, it often mimics bacterial infections, such as bacterial tonsillitis, which can represent a diagnostic pitfall and, consequently, increase the risk of developing complications. The aim of this case report is to highlight the complications resulting from the incorrect differential diagnosis of EBV-induced IM and its clinical significance.
View Article and Find Full Text PDFMedicina (Kaunas)
August 2025
Department of Pediatrics I, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Gheorghe Marinescu Street, No. 38, 540136 Targu Mures, Romania.
: A correct diagnosis of (GAS)-pharyngitis allows the prevention of complications and unnecessary use of antibiotics. The aim of this study was to assess the management of pediatric GAS-pharyngitis in Romanian general practitioners (GPs)' practice. : a cross-sectional study was conducted using a questionnaire distributed to Romanian GPs.
View Article and Find Full Text PDFJ Med Virol
August 2025
Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Rheumatoid arthritis (RA) is a chronic autoimmune disease whose exact pathogenesis remains unclear, despite links to genetics, environmental factors, and microbial dysbiosis. Recent studies have highlighted the role of the microbiome in RA, yet the contribution of the tonsil virome remains unexplored. This study aims to investigate whether changes in the tonsil virome are associated with RA progression and assess its diagnostic potential.
View Article and Find Full Text PDFJ Assoc Physicians India
July 2025
Assistant Manager, Department of Medical Affairs, Mankind Pharma Limited, New Delhi, India, Orcid: https://orcid.org/0009-0000-5356-3286.
Background: The growing threat of antimicrobial resistance (AMR) poses a significant challenge globally in the treatment of respiratory tract infections (RTIs). The PERCEPT survey aimed to capture Indian healthcare practitioners' (HCPs) perspectives on the prevalence of RTIs, AMR patterns, AMR diagnosis, and clinical evaluation of cefpodoxime and its combination with clavulanic acid in managing RTIs.
Materials And Methods: A structured questionnaire was used to conduct a cross-sectional survey among 1,000 healthcare professionals (HCPs) who manage RTIs in Indian adults and children, with 842 participants responding.