Use of Monospot Testing in the Diagnosis of Infectious Mononucleosis in the Collegiate Student–Athlete Population

Wang, Eric X.; Kussman, Andrea; Hwang, Calvin

doi:10.1097/jsm.0000000000000996

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…One recent study of 199 collegiate athletes undergoing mono testing showed elevated transaminase levels in 100% of the patients with Monospot and antibody-confirmed acute IM, whereas only 3% of the cohort without acute IM had this lab abnormality. 39 However, the importance of these transient elevations and any potential correlation to splenomegaly remains unclear and are not typically used to make RTP decisions.…”

Section: Laboratory Assessmentmentioning

confidence: 99%

American Medical Society of Sports Medicine Position Statement: Mononucleosis and Athletic Participation

Putukian

McGrew

Benjamin

et al. 2023

Clinical Journal of Sport Medicine

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Infectious mononucleosis (IM) is a common illness in children and young adults caused primarily by the Epstein-Barr Virus (EBV). Transmission occurs primarily through sharing oral secretions, thus IM is known as the "kissing disease." Common clinical manifestations include fever, pharyngitis, posterior cervical lymphadenopathy, and splenomegaly. Atypical lymphocytosis and transaminase elevations are common, and the diagnosis of IM is confirmed with laboratory findings of a positive heterophile antibody ("Monospot"), polymerase chain reaction, or antibodies specific to EBV. Individuals with acute IM may be quite symptomatic and not feel well enough to participate in sports. Splenic enlargement is common, with rupture a relatively rare occurrence, typically occurring within a month of symptom onset, but this risk complicates sports participation, and is often the reason for restricting activity. The management of IM is primarily supportive, with no role for antivirals or corticosteroids. The variability of clinical presentation and the risk of splenic rupture in patients with IM present clinicians with challenging return to play/return to sport (RTS) decisions. This position statement updates the Evidence-Based Subject Review on Mononucleosis by the American Medical Society for Sports Medicine published in 2008 and reviews the epidemiology, clinical manifestations, laboratory assessment, and management including RTS for the athlete with IM. This statement also addresses complications, imaging, special considerations, diversity and equity considerations, and areas for future clinical research. Understanding the evidence regarding IM and sport is essential when communicating with athletes and their families and incorporating shared decision-making in the RTS decision.

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Section: Laboratory Assessmentmentioning

confidence: 99%

American Medical Society of Sports Medicine Position Statement: Mononucleosis and Athletic Participation

Putukian

McGrew

Benjamin

et al. 2023

Clinical Journal of Sport Medicine

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“…On the contrary, test sensitivity is low (85% and even less than 50% in children under 6 years and in adults over 50 years). As a negative result for heterophile antibodies does not eliminate the diagnosis of IM, testing should be completed with EBV-specific serology [ 26 , 27 ].…”

Section: Infectious Mononucleosismentioning

confidence: 99%

Virological Markers in Epstein–Barr Virus-Associated Diseases

Lupo

Truffot

Andréani

et al. 2023

Viruses

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Epstein–Barr virus (EBV) is an oncogenic virus infecting more than 95% of the world’s population. After primary infection—responsible for infectious mononucleosis in young adults—the virus persists lifelong in the infected host, especially in memory B cells. Viral persistence is usually without clinical consequences, although it can lead to EBV-associated cancers such as lymphoma or carcinoma. Recent reports also suggest a link between EBV infection and multiple sclerosis. In the absence of vaccines, research efforts have focused on virological markers applicable in clinical practice for the management of patients with EBV-associated diseases. Nasopharyngeal carcinoma is an EBV-associated malignancy for which serological and molecular markers are widely used in clinical practice. Measuring blood EBV DNA load is additionally, useful for preventing lymphoproliferative disorders in transplant patients, with this marker also being explored in various other EBV-associated lymphomas. New technologies based on next-generation sequencing offer the opportunity to explore other biomarkers such as the EBV DNA methylome, strain diversity, or viral miRNA. Here, we review the clinical utility of different virological markers in EBV-associated diseases. Indeed, evaluating existing or new markers in EBV-associated malignancies or immune-mediated inflammatory diseases triggered by EBV infection continues to be a challenge.

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“…Heterophile tests in current use are mono test, mono diff, and monospot. One of the most commonly used tools in the clinical setting is the monospot test, which is a latex agglutination test that detects specific heterophile antibodies made in response to an EBV infection 8. Monospot tests are frequently ordered because of ease of access and rapid results in the clinical setting; a small blood sample is collected through a simple finger stick.…”

Section: Diagnostic Testingmentioning

confidence: 99%

“…monospot test, which is a latex agglutination test that detects specific heterophile antibodies made in response to an EBV infection. 8 Monospot tests are frequently ordered because of ease of access and rapid results in the clinical setting; a small blood sample is collected through a simple finger stick. Monospot only tests for EBV and not any of the other viruses that can cause IM.…”

Section: Chronic Ebvmentioning

confidence: 99%