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17 yo college student, comes to his physician with a 3 day history of fever, malaise, and sore throat. His vitals are PR 96/min, T 37.9, BP 110/70 mm Hg. RR: 15/min. His pharynx, soft palate and tonsils are erythematous and swollen. There are tender cervical adenopathy, splanomegaly and petechial lesions on skin and mucosa. Lab studies show: Hb: 14g/dL, WBC count: 15,000/uL, Neutrophils: 42%, lymphocytes: 50%, monocytes 5%, basophils 1%. Eosinophils 2%. Platelet count: 20,000/uL. Large basophilic lymphocytes with vacuolated appearance are seen. Monospot test is positive. What is the most appropriate next step in the Management?

A. serological tests
B. penciclovir
C. actaminophen and ampicillin
D. glucocorticoids
E. splenectomy

D....glucocorticoids.....infectious mononucleosis complicated by thrombocytopenia is an indication for steroids.

Right again. Monospot test positive is enough to Dx IM.