Which viral illness presents with fatigue and swollen lymph nodes?

• A. Mononucleosis
• B. Influenza
• C. Strep throat
• D. Common cold

Answer: (A)

Fatigue with swollen lymph nodes is a classic presentation of infectious mononucleosis caused by Epstein-Barr virus. This illness typically causes prolonged fatigue along with tender, enlarged lymph nodes in the neck (often posterior cervical nodes) and may be accompanied by fever and sore throat. Splenomegaly can occur as well, and many patients feel worn out for weeks. Lab tests often show heterophile (Monospot) antibodies and atypical lymphocytes, supporting the diagnosis. Management is supportive—rest, fluids, and avoidance of contact sports if the spleen is enlarged—since it’s viral and antibiotics don’t help.

The other options don’t fit as well: influenza usually presents with abrupt fever, body aches, and respiratory symptoms rather than prominent cervical lymphadenopathy; strep throat is bacterial and centers on a painful, red throat with tender anterior cervical nodes rather than generalized fatigue with lymph node swelling; the common cold tends to have milder symptoms with nasal congestion and cough and less prominent lymphadenopathy.