Increased sensitivity of new methods for detection of EBV antibodies and implications for infectious mononucleosis
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Mononucleosis
Heterophile
Immunofluorescence
(...) A disadvantage of the commonly used serological techniques in seed testing, e.g. immunofluorescence microscopy (IF) and enzyme-linked immunosorbent assay (ELISA), is the lack of distinction between viable and dormant or dead cells. This often results in a «grey» area of discrepancy between results of serological and traditional isolation assays. New techniques such as immunofluorescence colony staining, direct double diffusion in dilution plates, immunosorbent immunofluorescence and immuno-isolation combine isolation and serological techniques and have the potential to overcome this «grey» area
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Rapid diagnosis of Epstein-Barr virus (EBV)-associated infectious mononucleosis was compared by using nine kits and EBV-specific serology. Specific antibodies indicative of primary EBV infection were detected in 46 of 108 (43%) serum samples of infectious mononucleosis patients. The sensitivities and specificities of the rapid kits varied from 63 to 84% and 84 to 100%, respectively.
Mononucleosis
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A new rapid slide test for the detection of infectious mononucleosis heterophile antibody has been compared with the Paul-Bunnell absorption test. Out of 200 sera, 46 were seropositive for infectious mononucleosis by the Paul-Bunnell test and 43 of these were detected by the Monosticon test; the three Monosticon-negative sera were of low titre. There was no problem with false positive reactions due to heterophile antibody not specific for infectious mononucleosis.
Mononucleosis
Heterophile
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Mononucleosis
Heterophile
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Specific heterophile reactive antigen has been localized by means of indirect immunofluorescence in 12 of 13 kidney biopsy specimens obtained during the acute phase of infectious mononucleosis. I feel that this may represent the identification of infectious agent antigen. Evidence is also presented for the possible existence of two different strains of the agent of infectious mononucleosis.
Mononucleosis
Heterophile
Immunofluorescence
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Epstein-Barr virus (EBV)-specific antibody responses were determined in 43 consecutive pediatric patients who had signs and symptoms of inectious mononucleosis (IM) and positive diagnostic tests for mononucleosis (Monspot). Thirty patients gave clear-cut serologic evidence of primary EBV infections; of the remaining 13 patients, seven had no antibodies to EBV in the acute- or convalescent-phase sera and six showed serologic patterns of past EBV infections. Further testing proved that the initial Monospot results were either false-positive or were incorrectly interpreted in all 13 patients with unidentifiable illnesses but in only two of the patients with current EBV infections. The data confirm the occurrence of classical IM in children and show that the disease and the EBV-specific antibody responses can be virtually indistinguishable from adult cases.
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A slide test for infectious mononucleosis using formalinized horse erythrocytes (Monotest(2)) was quantitated and compared with standard differential heterophile (Davidsohn) titres performed on the same specimens. The Monotest titre parallels the standard presumptive heterophile (antisheep cell) titre in the degree of elevation, with a ratio of Monotest to heterophile titre of approximately 1 to 56. The simplicity of the quantitative slide test recommends it as a routine test for infectious mononucleosis.
Mononucleosis
Heterophile
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The clinical syndrome of infectious mononucleosis has been well described in the literature. The common symptoms include fever, sore throat, and swollen lymph nodes. However, there are other infectious agents that can produce similar symptoms, and for this reason, laboratory tests are used in conjunction with the physical examination to determine a diagnosis. The most common test used for the diagnosis of infectious mononucleosis is the rapid heterophile antibody test, which was first described as a diagnostic indicator for infectious mononucleosis in 1932. Due to its ease of use and minimal cost, it is often performed at the point of care. However, it has been shown that many patients do not produce heterophile antibodies. A review of the literature found studies that reported decreased sensitivity in patients younger than the age of 13 years. For this reason, a negative heterophile antibody result does not always rule out infectious mononucleosis, and if a diagnosis of infectious mononucleosis is still suspected after a negative heterophile antibody test, the primary care practitioner should follow-up with Epstein-Barr virus-specific serologies.
Mononucleosis
Heterophile
Sore throat
Atypical Lymphocyte
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Mononucleosis
Heterophile
Antibody titer
Agglutination (biology)
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