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Therapeutics/Prevention
Systematic review with meta analysis
No new evidence to support the routine use of steroids in the treatment of infectious mononucleosis
  1. Paul Lennon
    1. Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Limerick, Ireland
    1. Correspondence to : Dr Paul Lennon, Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Limerick, V94 F858, Ireland; paullennon81{at}gmail.com

    https://doi.org/10.1136/ebmed-2016-110404

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      Commentary on: Rezk E, Nofal YH, Hamzeh A, Aboujaib MF, Al Kheder MA, Al Hammad MF. Steroids for symptom control in infectious mononucleosis. Cochrane Database Syst Rev 2015;11:CD004402.

      Context

      Infectious mononucleosis (IM) is a non-genetic syndrome, with the classic triad of fever, pharyngitis and cervical lymphadenopathy, and lymphocytosis. Over 90% of cases are caused by the Epstein-Barr virus, a subclinical infection in childhood, to which 95% of the population have seroconverted by adolescence.1 Infection after this time will result in IM, a more severe illness than bacterial tonsillitis.2 Attempts are ongoing to expand the treatment armamentarium.3 Some reports supported the use of corticosteroids, but others showed these effects to be short lived. A Cochrane review, in 2006, concluded that there was insufficient evidence and the trials were too few, heterogeneous and of poor quality to recommend steroid …

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      Footnotes

      • Collaborators Michael Crotty and John E Fenton.

      • Contributors PL was invited to comment on the systematic review and meta analyses by Rezk et al as per the journal guidelines. MC and JEF, co-authors of PL on a review written about infectious mononucleosis, edited the manuscript prior to submission.

      • Competing interests None declared.

      • Provenance and peer review Commissioned; internally peer reviewed.