Qiological Community

Mononucleosis help

Hi all, I don’t have time to do a full write up at this time, but am wondering if you can help me with the information I have on hand. I will try to do a full write up in the next few days.
Patient is 16 year old female with mononucleosis. I saw her on Saturday and she presented with the following symptoms: severe throat pain, enlarged red uvula with enlarged red tonsils with pustules, alternating chills and fever, thirst for cold but throat pain makes it difficult to drink or eat, some sweating.
Body type: thin
Skin: moist. Got hives at onset of mono.
Temperature: warm to the touch. Gets hot flashes with alternating chills.
Complexion: dull and pale yellow
Neck: swollen
Emotions: very internal. Not emotive. Expresses herself well through writing. Initially came in for mood swings - anxiety/depression that has improved a lot.

I did +ub on right side and her face immediately got more color. Her neck felt a bit looser. Swelling of uvula improved On left side but throat pain persisted.

All continued to improve after Chai hu GUI zhi gan tang modified - especially swelling but mom took patient to the hospital eventually because of the throat pain. She got steroids and a pain killer. She is coming in again this week. She is still having alternating chills and fever, sweats and throat pain is still severe. I’m considering if +ub bilateral would be appropriate here or is that too much after already having done it once on one side.
Because of the severity of her condition I’m hesitant to treat along the lu/st confirmation because the fluid balance feels so precarious at this moment with a super dry mouth and super swollen throat. Any thoughts would be appreciated.
Thanks in advance

She was actually up all night with sleep apnea from enlarged uvula so mom is bringing her back today. All recommendations welcome

Pustules are reason enough to use LI+. The severe swelling and it being it in the throat strongly support LI+ too. If the swelling is reduced, her throat is likely to be less painful and circulation of fluids to her mouth will likely improve too.

Theoretically you could consider SI+ for the pain but LI+ makes more sense with this presentation.

UB+ didn’t make a big enough change to consider repeating it nevermind doing it bilaterally.

My notes say that the throat can be considered interior/exterior by the way.

Please let us know what you do and what happens.

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Thanks so much for your response! Makes sense. I did li+ on the right. It was hard for her to settle completely because as soon as she started to sink in she would have a sleep apnea response. It just felt right though - even though there wasn’t initially much change with her skin tone. By the end however she had color in her cheeks and was so much livelier and chattier (when she came in she looked ghostly). She also thought her neck and throat felt a bit better.

Oh…and she was surprised by the fact that she didn’t have any chills or fever or sweating while on the table. She did get a hot flash as soon as I took the needles out

this may be a bit late to use for your acute case but I second Kristin’s idea of SI+. I had a patient with throat polyps who felt a lot of swelling and discomfort there. ST+ and LI+ didn’t do much, but SI+ normalized the sensation while she was on the table, and it never came back.
The internal branch of KD channel goes to the throat.

Her mixed heat/cold pattern also makes sense for using SI+

Just wanted to follow up regarding this case - the girl is doing great. They referred to the li+ treatment as that treatment that really helped.

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