Any Role for Famciclovir in Severe Mono?

December 31, 2006

In Dr Navin Amin’s “What’s Wrong With This Picture?”case of a girl with infectious mononucleosis who had severepharygnitis and worsening dyspnea (CONSULTANT, December2003, page 1657), the patient was given parenteralhydrocortisone and later oral prednisolone.

In Dr Navin Amin's "What's Wrong With This Picture?"case of a girl with infectious mononucleosis who had severepharygnitis and worsening dyspnea (CONSULTANT, December2003, page 1657), the patient was given parenteralhydrocortisone and later oral prednisolone. In several of mypatients with infectious mononucleosis who had tonsillarenlargement and difficulty in swallowing, a regimen of famciclovirand prednisone was effective. However, I have notfound any support for this approach in the literature.---- Isaias Cupino, Jr, MD
Neillsville, Wis

It is well known that corticosteroids reduce inflammation,and they are indicated in patients with severe infectiousmononucleosis who have difficulty in breathing or swallowing.1 However, I have found no studies that eitherconfirm or dispute the use of famciclovir in this setting.Consequently, I would say that this must be an anecdotaltreatment; famciclovir does not have any activity againstEpstein-Barr virus, the cause of infectious mononucleosis.---- Navin M. Amin, MD
Professor of Family Medicine
University of California, Irvine
Associate Professor of Medicine
University of California, Los Angeles
Associate Professor of Family Medicine
Stanford University School of Medicine

References:

REFERENCE:1.

Godshall SE, Kirchner JT. Infectious mononucleosis. Complexities of a commonsyndrome.

Postgrad Med.

2000;107:175-179, 183-184, 186.