Unclear monospot false positive

[Texan1980]

Hello

let me start by saying I am nit at all sure this is STD related...

Up until month ago, I'd had no sexual contact for two years.. And before that mongamous for 5.  However, about a month ago, I started seeing a Female workmate... Mostly low risk activities... Protected intercourse and oral sex ( though I did have open canker sores from a stressful few months).

In any case, last week, I became fantastically fatigued to where I had to lay down in my office and fell asleep for a few hours. At the same, time one tonsil enflamed and there were white spots on it. I wentto a walk in clinic. They performed a monospot test, which the doctor said was positive for mono. The next day, I went to my regular doctor who sent blood out for the mor diagnostic test (iG) antibodies I assume. It came back negative for mono.

Since then, the sore throat and tonsil issues disappeared and I am left only with a profound mono-like fatigue... And having trouble explaining my absence at work.

My only true STD connection is that this came about just after resuming a sex life and knowledge that the person I am seeing has a much more extensive sexual history.

What could explain a positive monospot test but a negative followup test?  I also had shingles 2 months ago...

I know I  being a bit hypochondriac, but my doctor is extremely busy and it is difficultcult to get all of my questions answered in the short ole we have.  

Thank you

[Edward W Hook, MD]

To be honest this is a "could anything...." question to which the answer is of course it could, but it is unlikely.  From what you tell me I agree with the trained health care professional who told you most likely have mono.  I wouldn't start looking for zebras when you hear hoofbeats.  EWH

[Texan1980]

Thanks for your reply.  I guess what I was most curious about is whether or not a positive monospot test on Sunday and a negative iG test on Tuesday could mean something else....  Could something other than EBV or CMV trigger a positive monospot?

[Edward W Hook, MD]

Welcome to the Forum.  Mononucleosis is what health care providers call a "syndrome" meaning that there are a group of clinical findings which tend to go together.  Mono syndromes are most often caused by one of two viruses, the Epstein Barr virus (EBV) and cytomegalovirus. (CMV)  Either virus can be acquired in a number of ways but most often through casual contact in one's daily life or though exchange of secretions (kissing or sex).  It sounds like you had a positive test for mono.  These tests may not stay positive throughout the course of disease.  As a viral syndrome, you have little choice but to wait it out and not push yourself. In rare occasions the sore throat can be severe or persons can have dramatic swelling of lymph nodes.  

You will not know if you acquired this form the person you are seeing or in some other way.  Either way, there is not much to do with it other than, as I said, wait it out.  

Hope this helps.  EWH