Rosh Pediatrics Practice Exam

Why is posterior cervical lymphadenopathy noteworthy in this clinical scenario?

1. It is a common finding in viral infections

2. It suggests a clear diagnosis of streptococcal pharyngitis

3. It can indicate infectious mononucleosis

4. It rules out any serious illness

The correct answer is: It can indicate infectious mononucleosis

Posterior cervical lymphadenopathy is noteworthy in this clinical scenario because it is strongly associated with infectious mononucleosis, notably caused by the Epstein-Barr virus (EBV). In cases of infectious mononucleosis, posterior lymph node enlargement is a classic clinical finding, along with symptoms such as severe fatigue, fever, sore throat, and splenomegaly. While posterior cervical lymphadenopathy can occur in various viral infections, the distinction here lies in its significant correlation with infectious mononucleosis, which is an important condition to diagnose due to its potential complications and the need for specific management. This finding does not definitively diagnose streptococcal pharyngitis, which is more commonly associated with anterior cervical lymphadenopathy. Additionally, although posterior lymphadenopathy could indicate the presence of a serious illness, it does not rule out any serious conditions. The specific association with infectious mononucleosis makes it an essential consideration in the evaluation of a patient presenting with such symptoms.