The Use of Point-of-Care Ultrasound in the Diagnosis of Acute Infectious Mononucleosis in the Emergency Department

Study Overview
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Brief Summary
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The purpose of this study is to determine if splenomegaly on point-of-care ultrasound (POCUS) is an accurate and user-friendly surrogate to the heterophile antibody test and Epstein-Barr Virus (EBV) serologies to diagnose acute mononucleosis infection in patients presenting with sore throat to the Emergency Department (ED).

Detailed Description
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The investigators seek to determine whether the presence of splenomegaly on POCUS can accurately diagnose acute infectious mononucleosis in symptomatic ED patients, and determine the feasibility of performing point-of-care ultrasound for splenomegaly by emergency physicians in the emergency department setting.

Official Title
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The Use of Point-of-Care Ultrasound in the Diagnosis of Acute Infectious Mononucleosis in the Emergency Department

Conditions
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Infectious Mononucleosis, Splenomegaly

Intervention / Treatment
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* Device: Point-of-care ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged between 10 and 35 year-old presenting to the ED with suspected acute infectious mononucleosis Exclusion Criteria: Chronic infectious disorders (eg. tuberculosis, malaria, HIV, syphilis) Inflammatory disorders (eg. sarcoidosis, amyloidosis, systemic lupus erythematosus, Felty syndrome) Proliferative disorders (eg. lymphoma, leukemia, essential thrombocytopenia, polycythemia vera) Congestive disorders (eg: cirrhosis, portal hypertension, right heart failure, congenital heart disease) Chronic haemolytic anemia (eg. sickle cell, thalassemia, hereditary spherocytosis) Storage diseases (eg. Gaucher, Niemann-Pick) Splenectomy Inability to give informed consent

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Point-of-care ultrasound|Enrolled patients will undergo POCUS of the spleen by the treating emergency physician (resident, fellow or attending). Canadian Emergency Ultrasound Society (CEUS) certified residents, fellows and attending physicians will conduct the bedside ultrasonography after receiving specific training for the purposes of this study. The spleen will be assessed using a curved 2-6 Megahertz (MHz) transducer with the participant in the supine position. The cranio-caudal splenic length will be measured and its maximum dimension will be recorded on the standardized study data sheet.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of splenomegaly (maximal splenic cranio-caudal length) on point-of-care ultrasound | Splenomegaly is defined as a splenic length of > 11.5 centimetres (cm) for 10-12 year-old patients, > 12 cm for 12-15 year-old patients, > 12 cm for 15-35 year-old female patients, and > 13 cm for 15-35 year-old male patients. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Point-of-care ultrasound