Infectious Diseases Community
Acute Hepatitis and Mono
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Acute Hepatitis and Mono

I am a 30 years old male and 3,5 years ago (age 27) I suddenly fell ill with a fever (peak at 105 f) that lasted 13 days. Also bad tonsillitis, enlarged lymph nodes, malaise, anorexia, joint and muscle ache and a bad headache. Then I became icteric with dark urine and pale stools.
I noticed something very strange: I didn't like smoking (i am a heavy smoker)
CBC was:
WBC 24.2
RBC & PLT normal
WBC manual diff : Gran 17% Lympho 67% Mono 4% Reactive Lymphocytes 12%
Liver Panel:   SGOT/AST 148 H SGPT/ALT 245 H gGT 713 H Alkaline Phosphatase 497 H  Total Bilirubin 2.03mg/dl H Direct Bilirubin 1.41mg/dl H

C-Reactive Protein 105mg/L H

The diagnosis was infectious mononucleosis
Then I had the following tests:
EBV VCA IgM Negative EBV NA IgG Negative
CMV IgM Negative CMV IgG Positive
HAV IgM Negative
HBsAg Negative Anti HBs 1042 iu/ml Positive (I had the Hep B vaccine)
Anti HCV Negative Anti HIV 1&2 Negative
So based on the results the doctor said I don't have ebv or cmv but a lot of viruses can cause infectious mononucleosis-like symptoms. What i wonder is
what viruses could be the cause? And is CMV Positive suggesting that i could be sick with cmv but i didnt have detectable IgM antibodies at the time?

Avatar_dr_f_tn
Hi,
How are you? When "mono spot"  test results are negative, additional diagnostic tests may be done to differentiate EBV infections from a mononucleosis-like illness induced by cytomegalovirus, adenovirus, or Toxoplasma gondii.  Serologic testing is usually the method of choice for diagnosing primary infection. According to the cdc, laboratory tests for EBV are for the most part accurate and specific because the antibody response in primary EBV infection appears to be quite rapid.  and a distinction can be made as to whether a person is susceptible to EBV, has had a recent infection, has had infection in the past, or has a reactivated EBV infection. It is best that you discuss the results with your attending physician who is familiar with your history and results of your diagnostic tests for proper evaluation. Take care and do keep us posted.
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