IM may develop in people with a primary Epstein-Barr virus (EBV) infection, but this is not universal and depends on age of acquisition and other host factors. Diagnosis is confirmed by the classic presentation of fever, pharyngitis, and lymphadenopathy, along with atypical lymphocytosis, a positive agglutination test for heterophile antibodies, and a positive serological test for EBV-specific antibodies.General practitioners play an important role in the diagnosis of IM as they encounter the vast majority of patients with EBV-related disease.[31]

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