question on EBV test

[Robbens]

Hi all

I am suspecting that I have ebv in a recent exposure 1month plus ago with fatigue, photophobia, dry mouth and dry cough that won't go away and I am now waiting for the test results.

The test that I did was EBV EA-IGA blood test.

Can I know the accuracy of this test and what does this test detects in the blood? Thanks very much!

[mkh9]

Well, usually the test you for EBV Early antigen-or EA-D IgG, Viral Capsid antibody or VCA-IgM and VCA-IgG and EBV nuclear antigen or EBNA.

It is accurate but the antibodies can be variable with the EBV EA-D IgG.

When VAC-IgM and VCA-IGA is positive then it is new infection.  EA-D-IgG can also be positive in early infection but it also remain positive in 20% of people for the rest of their lives. if EBV-NA is present it is past infection.

The EBV-IGA can also be a test for nasopharngeal carcinoma. So I don't know why the doctor is testing the IGA instead of the IgM. Is there any talk about your nasal area being suspect as a problem? But they usually do a quantitative test when they are looking for this type of problem and look for certain markers. So it is unusual to see just the IgA being tested.

The symptoms of mono are very sore throat, high fever, swollen lymph nodes, fatigue and sometimes swollen spleen and/or liver.

Do you have any lesions on the nose area? If not they are probably just checking for mono. Have you had a complete blood count lately? Was it normal?

The symptoms you have are more like Mycoplasma pneumoniae or Chlamydophila pneumoniae. Did you get the symptoms after a flu or cold?

mkh9

[Robbens]

hi sorry for the late reply have been overseas and a big thanks for your time and reply, i have experience mild post nasal drip also for about 2 weeks till now. i only tested for monospot and ebv iga as it is only available in the clinic. the results came back negative for monospot test and 117 for ebv iga test which is in the equivocal range. I had a flu four weeks with a fever ago and went away. this is the 7th week since possible exposure since.

[Robbens]

to add on: i have muscle twitches from the lower back to legs for about 4 weeks till now. Thanks!

[mkh9]

So, your symptoms don't sound like mono at all. But, you could get a full panel for mono which includes the VCA IgG and IgM and EA IgGand EBNA IgG. The mono spot means nothing. It is totally inaccurate. It can only direct a doctor if you have the symptoms of mono and you didn't so it is a waste of money otherwise.

The muscle twiches may be low potassium or an imbalance in that plus the other electrolytes (sodium, potassium, chloride and CO2). Stress can cause that or not dehydration.  I can look up other reasons if you need me too but those are common ones. So you could get your electrolytes tested and/or a metabolic panel that includes the electrolytes.

Do you still have the dry cough? You could get the doctor to listen to your lungs and see if you might have Mycoplasma pneumoniae or get a PCR test for it. Usually they either give you an antibiotic if you have it or it will pass on its own if you have no immune problems. It takes a while. You can steam yourself. it makes you cough and breaks up the tightness and opens up the lungs and gets the bacteria out. Do you have pain when you breath in? Have you had a fever?

mkh9

[Robbens]

Hi,

Thanks for the information guess i will look for ways to get tested on the full panel for mono. I still have the cough but it seems to be better with mild post nasal drip now. i did not encounter any pain when breathing in. I got a fever during the 14th day since possible exposure which lasted for 2 days with lower back ache. I went to a doctor 2 weeks ago to check for chest infection and they did an x ray and informed me that its fine and no problem was found. Is is possible that i will not get mono even if im infected with ebv?

[mkh9]

How many days has it been since your exposure to possible mono?
I think it has been past the window for getting it but I'll check anyway.
You still sound like you have Mycoplasma. It may not show on an Xray. Only classic pneumonia does (Strep. pneumoniae). Where do you live (U.S.? and if so what state?). Just trying to rule out Coccidiodes. That is a fungus that gives you a fever and dry cough for a long period of time too. It really sounds like Mycoplasma. But generally you get rib pain when you breath in . So far you have no symptoms of mono.
mkh9

[Robbens]

Hi,

today is the 1st day of the 7th week since last exposure to possible mono. I am currently living in SG where i guess "mono" is still quite "rare" so screening for mono is hard to find in clinics. I tested for mycoplasma on the 12th~13th day after possible exposure. It stated M hominis no growth. Is it accurate for the screening for mycoplasma? or should i wait for a month before screening for it. Thanks very much!

[mkh9]

It takes 4-7 weeks to get mono. So you are about at the end of the time you would get it. So the symptoms you already have would be from something else. Where is SG? I don't know the initials. Mycoplasma hominis would not cause these symptoms only M. pneumoniae. If they did a PCR test it is accurate if they did a serology test it isn't that accurate and would depend on if you developed antibodies. Also whether they also checked for M. pneumoniae.  It would be better to get the PCR test done. But it just checks for presence of the bacteria. The serology you would have to get the IgM done at the beginning of the illness and IgM in 2-4 weeks to see if there is a 4 fold rise in the level of antibody. If you wait a month you can look for M. pneumoniae (not hominis) IgG but that will just tell you if you have ever been exposed and not recently.  M. hominis in the lung or throat is not a pathogen and doesn't cause disease there. It can cause problems in the genital tract. So they tested for the wrong bacteria. Unless they were using hominis as a negative control. I doubt it though.

So in short get a PCR test for M. pneumoniae. Either a sputum specimen or throat swab. Best to get a sputum or deep cough specimen.

mkh9

[Robbens]

Hi,

SG is singapore. Ok i will try to get a test on M. pneumoniae it seems quite rare for this kind of test in my region. I hope that it is really this that is causing the symptoms. What im worried now is the EBV EA- igA test that falls in the equivocal region at 117.

Negative :  126.5

Does M pneumonia cause painless sore on the penile head? And

im 24 this year, is it 100% that i will get mononucleosis symptoms if im infected with ebv?

[mkh9]

Yes I understand. Well, your symptoms don't sound like mono. Also, if you don't have it by now I would say in about one week if you don't have it by then you won't get it. Or by the end of 7 weeks. If that has passed you should be okay.

No Mycoplasma pneumoniae causes respiratory tract symptoms. It has nothing to do with the penis or the genital tract. If you have a painless sore there could your exposure be related to getting an STD? If so what does the penis sore look like? Is it like a syphilis chancre? It is a single firm painless not itchy skin ulceration. If exposed and it looks like that you should get tested for it. If it is rough textured and not an ulcer it could be HPV or something else. So could also get tested for HPV by PCR. But they usually just test women for this and you usually have more than one.

Regarding your last question if you have previously been infected with EBV you won''t get mono. If it is a recent infection you could potentially fight it off. But since you are already near or past the time you would get the symptoms you probably won't get it.
mkh9

[Robbens]

Hi,

the two painless sores looks like fungi infection sore just 2 small red patch on the penile head. got tested for herpes and other stds, results are negative. though i haven't got tested for hepatitis.

I believe this exposure is my first exposure of ebv. Hopefully its not an ebv infection. Thanks for your reply and information!

[Robbens]

Hi,

i have gotten back my results for ebv igm and igg both were negative. can i ask if mycoplasma ab igm and igg would be able to detect mycoplasma pneumonia? and is it be possible that i have caught the cytomegalovirus? suddenly i have got tinnitus a few days ago

[Robbens]

to add on: today im on the 9th week after post exposure

[mkh9]

Glad your EBV was negative.

As for Mycoplasma pneumoniae, Yes you can do a throat swab or sputum test for M. pneumoniae by PCR (more sensitive than serology) also the IgG and IgM will detect M. pneumoniae. It isn't as sensitive. The IgM comes up about the first month and goes away so you may not detect early infection by now. The IgG you would have to get paired sera so that you take one blood sample at the beginning of infection and another 4 weeks later to see  a 4 fold rise in titer. Otherwise, it just detects whether you were exposed to it some time in your life as the IgG antibodies stay with you all your life after several months. So the IgG can just detect past infection unless there is a rise in antibodies (4 times greater than the initial value).

CMV about 95-98% of adults have it by the time we are adults so it is not likely you got a new infection.

Tinnitus is very common. I get it off an on all the time. Mine is due to migraine most of the time. It can also be due to water in your ear, barometric pressure changes and a lot of other things.

Regards,
mkh9

[Robbens]

Hi mkh9,

Much Thanks for your time and reply. I'm now waiting for the screening results for M. Pneumonia and CMV. Actually i guess CMV is quite rare in my country and the symptoms are alike to EBV which is quite scary and worrying and it can infect someone easily by saliva. can i ask does CMV cause a prolonged low grade fever?

[mkh9]

These are general symptoms but I doubt you will be positive for CMV. You will probably have high igG for past infection negative IgM.

    Enlarged lymph nodes, especially in the neck.
    Fever.
    Fatigue.
    Loss of appetite.
    Malaise.
    Muscle aches.
    Rash.
    Sore throat.

I don't think it would cause a prolonged low grade fever. How low is the fever?

You can have a normal temperature of 99 in the afternoon. 100.5 or more is considered a fever in an adult. A primary fever would generally be higher for EBV and CMV.

mkh9

[Robbens]

Hi, sorry for the late reply as i'm overseas again and had just came back home and thanks for your time again.

My fever is about 37.2 degrees.

My candida antibody and CMV igM and CMV iGG came back negative.

You were right of my mycoplasma symptoms. The clinic just called me yesterday and my mycoplasma blood test antibody and titres came back positive. I guess i could have contracted mycoplasma pneumoniae.

Results is 1:160. For negative is < 1:40

Can i know what are the available antibiotics that i can take to recover for mycoplasma?


one more thing, whenever i get wet dreams my penis glands would itch like crazy is this associated with mycoplasma too? my candida AB came back negative.

[mkh9]

Was the M. pneumoniae test a serology test? Was it IgM postive or IgG positive or both or what? Or was it a PCR test?  Azithromycin or Clarithormycin (Macrolides) are what the treatment of choice unless you are allegic to it. But often M. pneumoniae resolves on its own. It does take a couple of months if you have "walking pneumonia". It is a dry cough with low grade fever and sometimes a stabbing pain in the rib area when you breath in. So it is up to the doctor to decide whether your lungs sound bad enough to warrant antibiotics. Also, if it is only your IgG that is positive it would past infection. If you IgM is also positive then it would be current infection or the PCR. So those are the options.

As for the other problem, the penis itching has nothing to do with Mycoplasma. Most likely it is a fungus. You can try a anti-fungal spray or cream such as terbinafine (Lamisil) on it for a week or two. Follow the package insert. This is similar to "jock itch". It is cause by a different fungi than yeast.
mkh9

[Robbens]

Hi mkh9,

yes its a serology test and igM was negative and igG was positive. Test was conducted 2months+ since possible exposure. Currently i still have minor post nasal drip for 6 weeks now, which started 4 weeks after possible exposure AND muscle weakness (maybe -> guillian barre syndrome).

Ok for the penis itching i will try a anti-fungal cream and see the results.

Thanks alot for your time

[mkh9]

Yes so you don't have current infection with Mycoplasma. The IgG will always be positive. Are you taking any meds that can cause the muscle weakness? I have been on two drugs that did that to me. One was a antidresant that was being used off label for something else. I was jogging 3 miles a day and after taking that antidepressant I couldn't run all of a sudden. And, then with a drug for osteoporosis I got muscle pain and had to stop it. So some drugs you have to watch out for even if they don't say on the package insert. But if not then yes some viruses can give you muscle weakness. It may be temporary or not. Also, some autoimmune diseases. It is something you may want to talk to a neurologist about or get tested for.  They have some tests for the muscles and nerves that you could possibly get.

Your first symptoms in the first post sound somewhat like TB. Have you ever been tested for that? The quantiferon gold test is good and doesn't cross react with the BCG vaccine if you had that. Although your chest Xray was normal. If it is early enough you may not have produced a nodule in the lung. Just a thought. You don't have night sweats right?  or night fevers? Hard to diagnose these types of things.

mkh9

[Robbens]

Hi, i am not taking any medicine before this infection (mycoplasma). is TB tubercolosis? i didn't get tested for that. i've got night sweat if i cover my whole body including the head using a blanket at night in an air con room but im not feeling hot when i cover my whole body with that, just that when i woke up during midnight i will find myself sweating. if im sleeping in normal room temperature i dont have this issue.

Can tubercolosis cause post nasal drip? It has been quite long since i got this post nasal drip about 6-7 weeks now and im worried.

[mkh9]

Yes TB is tuberculosis but no it doesn't cause post nasal drip. Usually, you get night sweats, a lot of fatigue, productive cough eventually with a rusty sputum and low grade fever.  Maybe you are allergic to something that causes the post nasal drip. Post nasal drip can cause a sore throat as well.
mkh9

[Robbens]

Hi, thanks for the explanation. i guess my post nasal drip should be related to my mycoplasma infection.... it's been 6 to 7 weeks since it started.. Can i ask if full recovery is possible for mycoplasma??

[mkh9]

Well, usually you don't get post nasal drip with Mycoplasma. Yes you usually fully recover from Mycoplasma. But it takes a couple of months. But you had antibodies for past infection. But if you took the blood test a month or more after the initial infection you won't see IgM so that would make sense.  It depends on when you tested.
mkh9