Help with fever and EBV results

I am a 30 yr. old female and have been suffering with fatigue and low-grade fever for 8 weeks.  Normally my temp runs 97.3-97.5....For the past 8 weeks it has not been 98.4-99.9....But never above 100.  Although this does not seem high, it has made me feel awful.  I can tell when my temp is going up...I feel tired and headachey.  The one time that I felt my fever break and had sweating...It actually went down to 97.3 and I felt super great.  

Many tests, sinus CT normal, TB skin test normal, Chest X-ray normal, CBC normal, metabolic panel normal, HIV negative,  CMV showed high antibodies, otherwise normal.......the only tests that came back abnormal were the EBV.  
Epstein-Barr Virus VCA (IGM AB)  0.38  (normal)
Epstein-Barr Virus VCA (IGG AB)  6.09  (high)
EBV Nuclear Antigen (EBNA)       2.60  (high)

Although my doctor said the results were only indicative of a past infection, I read that normal IGM, with high IGG and EBNA can be indicative of a reactivated infection.   Could this be at all correct?

What other tests would you recommend be run for a low grade fever and fatigue without an apparent cause?

[Kevin Pho, MD]

It is true that the elevated IgG Ab is suggestive of past infection.  

Yes, a positive EBNA is suggestive in most cases of past infection.  However, the appearance of EBNA antibodies in a patient who was previously VCA (viral-capsid antigen) positive and EBNA negative is highly suggestive of recent EBV infection.

If EBV has been eliminated as a cause, you can consider blood cultures, thyroid tests, liver panel, HIV testing and rheumatological testing to help find a cause.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[pritts027]

A related discussion, EVB blood test what does it mean?? was started.