Mononucleosis Diagnosis

A doctor will probably ask a number of questions about your symptoms, medications you are taking, medical conditions, and family history, before making a mononucleosis diagnosis. He or she will most likely perform a physical exam. In the case of mononucleosis, diagnosis of the illness can be difficult because the symptoms of mono can be very similar to other illnesses. For this reason, doctors often recommend tests -- such as the monospot blood test -- to determine what is causing the symptoms.
 

Mononucleosis Diagnosis: An Overview

In order to make a mononucleosis (mono) diagnosis, the doctor will likely ask a number of questions about a person's symptoms, medications, other medical problems, and family history of medical problems. The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of:
 
  • Fever
  • Sore throat
  • Swollen lymph glands
  • Age of the patient.
     
Usually, the doctor will also perform a physical exam. Finally, because mono symptoms can be very similar to other illnesses, doctors often recommend tests to find out exactly what the problem is.
 

Using the Monospot Test to Make a Mononucleosis Diagnosis

The test most commonly used to make a mononucleosis diagnosis is the mononucleosis spot test. This blood test detects the antibodies (proteins) that the body makes to fight the Epstein-Barr virus (EBV) or cytomegalovirus (CMV). Because it takes awhile for antibodies to develop after infection, your doctor may need to order or repeat the test one to two weeks after you develop symptoms. At that time, the test is about 85 percent accurate.
 
Other tests your doctor might order to help in diagnosing mononucleosis include:
 
  • A complete blood count (CBC), to see if your blood platelet count is lower than normal and if lymphocytes are abnormal
  • A chemistry panel, to see if liver enzymes are abnormal.
 
If your throat is sore, having a throat culture is usually a good idea, for several reasons. First, the symptoms of mono and strep infection, including that caused by Strep-A (a particularly serious form of strep), are very similar. Second, strep throat or other throat infections can develop anytime during, or shortly after the disease. In any case, it's important that throat infections be diagnosed as soon as possible and treated with antibiotics that can kill the organism responsible for the infection.
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD