Infectious mononucleosis is a viral disease from the family of herpes infections, infection of which occurs through airborne droplets or by contact. The cunning of this disease lies in the fact that at the initial stage it can be easily confused with angina or flu. Therefore, in order to make a correct diagnosis, it is very important to make a diagnosis that allows you to confirm or deny the presence of Epstein-Barr virus in the body. The most accurate results will show a blood test.
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Infectious mononucleosis: a blood test – the most accurate diagnosis
If an infectious mononucleosis is suspected in a patient, the doctor prescribes a blood test. Since the incubation period of this disease can last up to one and a half months, only a blood test will help determine if there is a virus in the body. In addition, the course of infectious mononucleosis is characterized by periods of remission and exacerbation, during which the symptoms manifest themselves in different ways, so the importance of accurate diagnosis is difficult to overestimate.
Having failed to conduct due examinations and diagnose only on the basis of external signs, the doctor may mistakenly recommend the patient antibiotic therapy, which is absolutely powerless against infectious mononucleosis, which requires antiviral treatment.
A very important role is played by the diagnosis of this disease in pregnant women. If the blood test confirms the presence of infectious mononucleosis, then, most likely, the pregnancy will have to be interrupted. Also, such tests will be useful to pass and future parents who are just planning a pregnancy. Indeed, according to the unanimous opinion of doctors, it is highly desirable to avoid pregnancy within six months after suffering the disease.
You can take blood tests for infectious mononucleosis as directed by your doctor, or on your own initiative. Such analyzes are done in state laboratories and in private medical centers.
What blood tests do with mononucleosis?
To make a correct diagnosis, it is advisable to pass such tests as:
- general blood analysis;
- blood chemistry;
- analysis of antibodies Epstein-Barr.
Also, those who have suffered mononucleosis, or who the doctor suspects of having this disease, should be tested for antibodies to HIV. In order to have a complete understanding of the patient’s health, it is highly desirable to undergo this laboratory examination three times. During the acute period, after three months and after three years.
This is necessary in order to distinguish between the virus of mononucleosis and HIV infection, because the mononucleosis-like syndrome is also characteristic of HIV infection in the primary stage.
Complete blood count for infectious mononucleosis
If the virus is present in the body, then in the general analysis of blood, leukocyte and lymphocyte counts will be exceeded. If infection has occurred recently (within 7 days), then atypical lymphocytes will be visible in the blood. The presence of the disease will indicate an increase in these cells in the blood up to 10 percent. The largest number of them (up to 20 percent of all blood cells) will appear in the second week. Then their number will gradually decrease. Atypical lymphocytes, or mononuclear cells, are elements of a round or oval shape that can be the size of a large monocyte. Here it is very important, having seen the results of the analysis, to exclude initially other diseases with similar symptoms – acute leukemia, Botkin’s disease, pharyngeal diphtheria, etc.
Some patients may have moderate leukocytosis or even leukopenia in the general blood test. ESR (erythrocyte sedimentation rate) will usually be moderately increased, but there will be more monocytes than usual — more than 10 percent. The level of lymphocytes can reach more than 40 percent. The number (over 6 percent) and band neutrophils will increase. If the disease is not complicated, then the number of platelets and red blood cells will be normal. If, on the background of mononucleosis, complications have developed, these indicators will be significantly reduced.
Biochemical blood test for infectious mononucleosis
Biochemical analysis will show a significant increase in aldolase – two to three times. An increase in alkaline phosphatase may also be noted (tests may show more than 90 U / L). If jaundice is manifested against the background of infectious mononucleosis, the analysis will show an increased level of bilirubin (mostly direct fraction). If there is a significant increase in the bilirubin in the indirect fraction, this may indicate the development of autoimmune hemolytic anemia, a very serious and dangerous complication.
Analysis for specific antibodies
The analysis for specific antibodies not only helps to identify whether the patient has Epstein-Barr virus in the body, but also to establish whether he is in an active state or the patient is already recovering. For example, in a person with an active form of mononucleosis, specific IgM immunoglobulins will be present in the blood, while at the recovery stage, the analysis will show the presence of IgG antibodies.
Monospots with infectious mononucleosis
Monospot is a fairly effective diagnostic method for patients who recently contracted mononucleosis (2-3 months ago). This test will not help to detect the chronic form of infectious mononucleosis. In the course of this analysis, the blood is mixed with special substances, and if agglutination starts and heterophilic antibodies become visible in the blood, the diagnosis is confirmed.
How to donate blood in infectious mononucleosis
- In order for the results of the studies to be most reliable, one must pass the prescribed analysis strictly on an empty stomach.
- The last time you need to eat food is eight hours before going to the laboratory.
- If you want, you can drink water before the analysis, albeit in small quantities.
- It is necessary to stop taking medication for two weeks before the analysis.
- A day before the blood sampling, you should exclude any fatty foods and alcohol.
- For two days before the analysis, it is advisable to avoid physical exertion, and prefer a quiet pastime.
- It is also highly desirable to avoid disturbances on the eve of the analysis.
Why is it necessary to donate blood for infectious mononucleosis several times?
At different times during the course of this disease, blood tests may be different. This is due to the fact that at the initial stage, mononucleosis manifests itself inactive. In the blood analysis, there will only be a slight increase in the number of stab neutrophils and a decrease in the number of segmented cells.
A recurrent blood donation can be prescribed by an infectious disease physician during the acute phase of the disease in order to make sure that the correct diagnosis is made.
After recovery, a blood test is also needed to ensure that the treatment was effective and brought results.
If we are talking about a child, then the pediatrician may prescribe him clinical and laboratory blood tests every three months. Also, twice a year, it is useful to pass an HIV test.
For some young patients, a pediatrician may recommend monitoring by a pediatric hematologist. Also during the year, babies should limit physical exertion, sunbathe with care and not do prophylactic vaccinations.