Acute Tonsillitis in Infectious Mononucleosis (EBV Infection): Suspected or Confirmed

This protocol covers acute tonsillitis arising in the context of suspected or confirmed Epstein-Barr virus (EBV) infection — infectious mononucleosis. The viral aetiology and the distinct risk of pronounced tonsillar enlargement define both the treatment focus and the specific precautions that apply.

When EBV infection is suspected or confirmed, the focus of treatment is directed at supportive management of the underlying viral illness. Significant tonsillar hyperplasia can develop in this setting, raising the possibility of upper airway compromise and influencing certain management decisions. There are also specific contraindications unique to this infectious context that differ from standard tonsillitis management.

Supportive measures form the cornerstone of treatment. In cases where tonsillar enlargement is substantial, additional anti-inflammatory intervention may be considered. The complete protocol — including the full clinical algorithm, all contraindicated agents, and the sequence of management decisions — is available via the structured regimen.

Downsizing of the tonsils with relief of upper airway obstruction.