Case Report: Smudge Cells a Valuable Prognostic Marker in Infectious Mononucleosis

Abstract Infectious mononucleosis is a very common infection. It is mostly caused by Epstein-Barr virus (EBV) belonging to herpesviridae or sometimes by the other member, Cytomegalovirus (CMV). It spreads through saliva. It has typical symptoms like fever, extreme fatigue, sore throat and tonsillitis, enlarged lymph nodes in the neck, armpit, skin rashes, body ache, and obstruction in the upper respiratory tract, enlarged spleen and liver. It can have other complications like anemia, encephalitis, meningitis, inflammation of the kidney, heart muscles, and rupture of the spleen. Laboratory diagnosis is costly. The physician may order heterophile antibody tests (mono-test), EBV or CMV specific antibody tests, and viral DNA load. Financially weaker patients do not want to go for such tests. In this study we suggest careful observation of a blood smear for atypical lymphocytes and smudge cells (Downey cells) could also be the cheapest way to look at the problem, although it is not a confirmatory test.