What does a negative mononucleosis (mono) screen with presence of Epstein-Barr virus (EBV) early antigen IgG indicate?

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Differential Diagnosis for Mono Screen Negative, but EBV Early Antigen D IgG Positive

  • Single Most Likely Diagnosis
    • Past EBV infection: This is the most likely diagnosis because the presence of EBV early antigen D IgG indicates a past infection. The mono screen being negative suggests that the patient is not currently infected with EBV.
  • Other Likely Diagnoses
    • Chronic EBV infection: Although less common, some individuals may have a chronic EBV infection, which could explain the positive IgG result.
    • False-negative mono screen: It's possible that the mono screen was a false negative, and the patient may still have an active EBV infection.
  • Do Not Miss Diagnoses
    • Burkitt lymphoma: Although rare, Burkitt lymphoma is associated with EBV infection, and a positive IgG result could be a clue to this diagnosis. Missing this diagnosis could be deadly.
    • Nasopharyngeal carcinoma: This rare cancer is also associated with EBV infection, and a positive IgG result could be a red flag.
  • Rare Diagnoses
    • EBV-associated hemophagocytic lymphohistiocytosis (HLH): This rare and potentially life-threatening condition is associated with EBV infection.
    • X-linked lymphoproliferative disease (XLP): A rare genetic disorder that affects the immune system's response to EBV infection, leading to severe complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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