[Clinical aspects of the diagnosis and treatment of infectious mononucleosis in primary care and in departments of infectious diseases].

Medical documentation of the 342 patients hospitalised for infectious mononucleosis at the departments of infectious diseases of two county hospital was retrospectively reviewed between 1990 and 1996 and the most important clinical data were recorded. In order to document the effect of control measures, which were taken for the improvement diagnosis and therapy, data of the 105 infectious mononucleosis patients at one of the mentioned departments were also recorded in 1997 and 1998. The length of the time before the hospital admission (avg. 10.3 days), the length of the hospital stay (avg. 9.2 days) and the respectable amount of antibiotics taken for this indication show that this disease has great cost effect. High rate of classical clinical signs (fever, pharyngitis, lymphadenopathy, atypical cells) indicates, that the majority of the patients consulting their doctors presented the well-known signs of the disease. Only 43.6% of the patients were diagnosed as infectious mononucleosis by the G. P. s. Majority of the cases were treated for tonsillitis. 90.7% of the patients were given antibiotics before the hospital admission (avg. 1.6 antibiotics/person). 43.3% of the patients left the hospital without serologic diagnosis. After drowning lesson from the first part of this study, there was significant decrease in the rate of lack of serologic diagnosis and in the amount of consumption of antibiotics for this indication in the hospital, but there was no change at the level of G. P. s. The results of this paper demonstrate that the daily routine diagnosis and treatment of a well-known diseases differs remarkably from optimal practice. The fact is, that even if the physician has knowledge of a certain disease, does not necessarily mean that he uses it in his routine work. In order to reduce this failure, authors propose introduction of protocols and regular review of the practice.