Chief Complaint: “I’ve had a sore throat, fever, and fatigue for the past week.”

History of Present Illness:
A 19-year-old college student presents to the clinic with a one-week history of fever, sore throat, and extreme fatigue. He also reports swollen glands in his neck and occasional headaches. He denies cough, shortness of breath, or recent antibiotic use.

He is a first-year student living in a dormitory and recently attended several social gatherings. He reports kissing his new girlfriend frequently but does not recall any recent illness in her. He has never had similar symptoms before.

Past Medical History:

• No significant past illnesses
• No history of tonsillectomy

Physical Examination:

• Temperature: 38.5°C (101.3°F)
• Throat: Erythematous with bilateral tonsillar enlargement and exudates
• Lymph nodes: Marked cervical lymphadenopathy (tender and swollen posterior cervical nodes)
• Abdomen: Mild splenomegaly, no tenderness

Diagnosis:
Based on the clinical presentation, the most likely diagnosis is infectious mononucleosis caused by Epstein-Barr Virus (EBV).

Diagnostic Tests:

• Heterophile antibody (Monospot) test: Positive
• Complete blood count (CBC): Lymphocytosis with atypical lymphocytes
• Liver function tests (LFTs): Mildly elevated

Management Plan:

• Supportive care: Rest, hydration, and symptomatic treatment with acetaminophen or ibuprofen
• Avoid contact sports for at least 3-4 weeks due to risk of splenic rupture
• No antibiotics, especially amoxicillin or ampicillin, which may cause a rash in EBV-infected patients
• Education: The virus spreads through saliva and can remain dormant in the body after recovery

The patient is advised to rest and return for follow-up if symptoms persist or worsen.