Do I really have Mono

Hi I posted a question earlier but i got my data all backwards so I am trying again...sorry for the confusion. Here we go, back in January i had a sore throat and swollen nodes and went to the doc two or three weeks after my infection. well we did a heterphile (monospot ) test qualitative and it was negative and my cbc was good, no abnormalities what so ever, no even a slight increase in WBC, lymphs, or atypical lymphs. well this march i went back to the doc bc my nodes felt like goiters but no sore throat. we did a cbc and it was perfect and WBC and atypical lymph were all in range. we did a EBV panel and the results were as followed:
please keep in mind that < 90 means negative

Viral Capsd IgM= 14= negative
Early Antigen IgG= 118= positive
Viral Capsid IgG= 1984= positive
EBNA IgG= 2003= positive

1. with this my doc said that i have reactivated mono but my question is that i have no symptoms and all of my other labs are normal then how can this be mono?
2. i have read that once you have mono you dont get it again unless you have hiv or suppressed immune system, is that true
3. is it possible that my EA IgG is high from when i previously got mono but i honestly dont remember when i might of had mono
4. what do you think- i know that the last two antibodies are high bc it shows a past infection but can early antigen be high and indicate a recent infection
5. are mono antibodies constantly circulating in the body or do they increase when the virus is in the body- basically if this is a second infection then would i still produce IgM antibodies or only IgG antibodies are produced during recurrent infections.

please help me i am so uterly confused

[J.M. Keyes, MD]

Hi again,
I do not think you have mono-
The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Usually, laboratory tests are needed for confirmation. Blood tests include an elevated white blood cell count, an increased percentage of certain atypical lymphocytes, and a positive reaction to a "mono spot" test.

Yes, you can have EBV antibodies and not have mono- from the CDC: "Although the symptoms of infectious mononucleosis usually resolve in 1 or 2 months, EBV remains dormant or latent in a few cells in the throat and blood for the rest of the person's life. Periodically, the virus can reactivate and is commonly found in the saliva of infected persons. This reactivation usually occurs without symptoms of illness."

After EBV exposure, your IgG and EBNA will be positive for life.  A positive early antigen indicates reactivation, which as stated above may not be symptomatic, which I think is your case.  
When you get EBV as an adolescent or child, it results in mono only 35-50% of the time, so it is quite possible that you were exposed to EBV and didn't actually get mono.

I hope this helps.
JMK MD

[worriedsick7]

is it possible to have the antibodies for EBV but never have mono? also can the body produce EA IgG antibodies but not have infectous mono

[PenPens]

A related discussion, Did I have mono? was started.