Infectious mononucleosis testing at the point-of-care

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.