Lab Case 57

A 19 year old girl presents with a sore throat and feeling generally unwell. She has difficulty swallowing. On examination – her tonsils are enlarged and inflamed.

Temp = 38

Her blood results are as follows:

Hb  140 (115-155 g/l)

platelets 149  (150-400)

WCC  16.2  (4-11)

Neutrophils  3.1 (1.7-7.5)

Lymphocytes  12.6 (1.3-4)

Bilirubin 57  (<16 umol/l)

ALP  410 (35-115) U/L

GGT  220 (<31) U/L

ALT  582  (<31) U/L

CRP 21

Monospot negative

Blood film shows several atypical mononuclear cells and numerous reactive lymphocytes.

Describe and interpret

Give a differential diagnosis

What are the tests are indicated and why?

How will you treat her?