When the Test is Negative

Routine Checking by the Doctor

When testing for mono, the doctor will take a full medical history and do a physical exam. These are both very important diagnostic tools when it comes to mononucleosis. During the course of these exams the doctor will ask about symptoms and possible exposure to the disease as well as check for signs of the infection. If the doctor feels there is a need for further confirmation, or if he feels there may be another cause for the symptoms, he will order blood tests.

When Blood Tests are Necessary

Along with the monospot and EBV antibody tests, a complete blood count (CBC) may be done to rule out other types of infections. He may also ask for a liver test which would show if the virus has affected the liver. Blood testing to confirm mononucleosis is often done when symptoms progress beyond a stage where they are easily treated and become more serious. However, it often makes little difference to the method of treatment prescribed for the illness unless matters have escalated.

When Blood Testing Isn't Helpful

Sometimes blood testing is done, but the results are not helpful. There are different reasons for this, some of which we will cover in this article.

Mono tests are done to find antibodies which would indicate the presence of the Epstein-Barr virus in the blood. A quick screening test that is often done to confirm a diagnosis of mononucleosis is the monospot test that detects the heterophil antibody, which forms during some types of infections. This test does not require extraction of a lot of blood, it is simply a prick to get a drop of blood which is placed on a microscope slide and mixed with other substances. If the heterophil antibody is present, the blood will clump or agglutinate. If this test is administered within the first few weeks of becoming infected with mono, you may have a false-negative result. If you continue to have symptoms after the test has indicated a negative result, it is a good idea to be retested.

Maybe It Isn't Mono...

There are other infections and diseases which have symptoms very much like mono. These include cytomegalovirus, leukemia or lymphoma, rubella, hepatitis or lupus. A monospot will usually show a negative result if the illness is one of these infections. Also, quick diagnostic tests for mono are not useful when applied to children under the age of four and those under the age of two years will be more likely than an adult to have a false-negative monospot test even when they have mono.

Chronic Fatigue Syndrome Link

It was once thought that the Epstein-Barr virus may be related to chronic fatigue syndrome, although that theory has pretty well been abandoned. Nevertheless, the monospot test and the EBV antibody test are not used to diagnose chronic fatigue syndrome or to monitor the condition.


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