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Infectious mononucleosis is an acute self-contained disease, mostly caused by the Epstein–Barr virus (γ-subfamily herpes virus), and not rarely by cytomegalovirus (β-subfamily herpes virus). Clinical manifestations in the head and neck area include fever and cervical lymphadenopathy, as well as exudate in the faucial tonsils and pharyngitis. The latter manifestations frequently prompt an Ear, Nose & Throat (ENT) assessment. ENT surgeons, in contrast, are traditionally trained not to prescribe amoxicillin in cases of suspected infectious mononucleosis because of the risk of developing antibiotic-induced skin rash. Hence, they often resort to prescribing cephalosporins in doubtful cases, which are believed not to carry such a risk (1).

How Safe is It to Prescribe Cephalosporins in Patients with Infectious Mononucleosis? Implications for Clinical ENT Practice