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Family Medicine (Expert Forum)
Help with fever and EBV results
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Help with fever and EBV results
by 5417girl, Apr 04, 2006 12:00AM
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?
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?
Doctor's Answer
by Kevin Pho, MD, Apr 05, 2006 12:00AM
, Apr 05, 2006 12:00AM
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
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
Member Comments
by pritts027, Dec 26, 2008 10:51AM
A related discussion, EVB blood test what does it mean?? was started.
