What Is The Cause And Treatment For Mononucleosis?

Posted on Sat, 13 Sep 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 13 Sep 2014 Answered on

Tue, 7 Oct 2014 Last reviewed on

Question : I am 43 and I was diagnosed with mono back in March. I went to the dr. because I just hadn't felt very well for several weeks. I was and still am exhausted all the time, no energy. They did a mono spot test which turned out to be positive and he told me I had mono and it was an new infection. I have had a chronic cough for quite sometime and was told it is from the ACE Inhibitor I took for my blood pressure. I have been off of the ACE Inhibitor for three weeks now and cough is not better(they told me it could take sometime). I have had a persistent high WBC for at least the last year (anywhere from 11 - 22.5) neutrophils normally high, sometimes lymphocytes, neutrophils, and monocytes all high. I have also noticed my MCHC is sometime low (not by much still in lower 30s) I went to request all of my blood tests results from the last year or so to take with me to an appointment I have with a Hematologist next week.
This is when I came across my EBV tests from March. I tested positive on mono spot test, positive on Eps-Barr Viru Capsid Ag IgG Ab with signal strength of 257, positive on EBNA Ab IgG with signal strength of EBVNA 204, and negative on Epps-Barr Viru Capsid Ag IgM Ab with signal strength of 15 for EBV Capsid AgIgM.
Just hoping there is someone who can help me clarify some of this information. I remain exhausted, run unexplained low grade fevers, periodic night sweats, and still have cough and elevated wbc often. Could the mono back in March been something else?

Answered by Dr. Shoaib Khan (1 hour later)

Brief Answer:
Information provided points only towards mono

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. I shall first provide you with some basic information, for your better understanding. Mono (mononucleosis) is caused by the virus called Epstein Barr virus (EBV). To make a diagnosis of mono, we need to test the individual not just for the mono spot test (which is done to determine a quick result, but a more specific investigation is conducted like the ones you have mentioned above, to confirm the infection).

The test results you have mentioned confirm the diagnosis of mono, and are all consistent in pointing towards the same.

As for all your symptoms: regular fevers, lethargy, tired all the time, night sweats, lowered immunity, etc; these are all consistent with the clinical picture relating to the mononucleosis. The clinical picture provided by you ma'am, coupled with the fact that the laboratory analysis backs up the suspected diagnosis, I do not think there is any doubt or suspicion about any other underlying conditions that could have caused this ma'am.

In conclusion, based on the provided information a diagnosis of mono is quite clear without any suspicion of any other underlying conditions. I hope you find my response helpful ma'am. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.

Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shoaib Khan (2 hours later)

Thank you for the information you provided. Would it be safe to say then even though I am still experiencing these issues 6 months after the initial tests, it is the mono that is responsible?

Answered by Dr. Shoaib Khan (7 hours later)

Brief Answer:
It most certainly can be ma'am

Detailed Answer:
Hello once again ma'am.

The thing with mono is that once an individual is infected they may carry the infection in a dormant manner for the resr of their life. But when their immunity drops, the infection can reactivate with symptoms recurring.

In some individuals, these symptoms may not disappear for a while as they are permanenetly immunocompromised (eg. An individual undergoing chemotherapy, infected with AIDS, etc.).

So it is possible for an individuals symptoms to recur, although this is less commonly seen. I hope you find my response helpful. Please do not hesitate to write to me anytime, I am always here to help.

Best wishes ma'am.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar