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Diagnostic Test – Monospot Test
1. What is this?
The Monospot test is the best initial screening test used to diagnose infectious mononucleosis (IM).
It detects heterophile antibodies, which are characteristically produced during infection with Epstein–Barr virus (EBV).
2. When do you answer Monospot test?
Answer Monospot test when the clinical vignette describes:
- Sore throat
- Fever
- Lymphadenopathy (especially posterior cervical)
- Malaise and fatigue
- Splenomegaly (present in ~50% of patients)
- Exudative pharyngitis (may be present)
- Rash occurs in ~15% of cases normally
- Rash in ~90% of patients if ampicillin or amoxicillin is given
3. What is the most accurate test?
- The most accurate test in the acute phase is:
- IgM antibody to EBV viral capsid antigen (VCA)
- EBV nuclear antigen (EBNA) antibodies appear later, usually 3–4 weeks after infection, and are not useful for acute diagnosis
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