Infectious Diseases Current Topics in Infectious Diseases

A New Way of Detecting Mono

The symptoms of mononucleosis and viral tonsillitis—fever, sore throat, swollen glands and white patches in the back of your throat—are similar, often making it hard for a doctor to distinguish between the two during an office visit.

However, researchers have discovered that a routine blood test may help your doctor determine which of these viral diseases you have, ensuring that you get the most appropriate care quickly.

“[The goal was] to find a quickly available screening tool,” wrote the study authors from St. George’s Hospital, London.

Mononucleosis, best known as the “kissing disease,” is a contagious disease caused by a virus, and usually passed from person to person via saliva or mucus. While it will generally pass on its own in a healthy person, mononucleosis causes fever, sore throat and malaise. In some patients, however, mononucleosis can cause serious side effects, including internal bleeding. Therefore, a rapid diagnosis is important.

Until now, the best tool to determine if a patient had mononucleosis was the Monospot test. This test uses a blood sample to look for antibodies created by the immune system in response to the infecting virus.

However, the Monospot is expensive and not very accurate early in the disease, as antibody levels do not peak until a person has had mononucleosis for over a week. So, a patient with an inconclusive Monospot results will need additional testing. Therefore, a new test which is more accurate in the detection of mononucleosis is welcome news.

This test, analyses white blood cells directly via a routine blood sample and seems to be able to more accurately determine if the a patient’s sore throat is the result of mononucleosis.

In a study, published in the Archives of Otolaryngology, researchers looked at the white blood cell counts in 220 patients of whom 100 had tonsillitis and 120 had mononucleosis. Those patients with mononucleosis had a higher average number of lymphocytes, a specific type of white blood cell, than those with tonsillitis.

In fact, the authors conclude, this test can accurately diagnose mononucleosis 90 percent of the time, better than the Monospot test’s 85 percent effectiveness and at a cheaper price.

"The specificity and sensitivity of this test seem to be better than the mononucleosis spot test itself," the authors write.

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