Differential Diagnosis for EBV Serology Results
Single Most Likely Diagnosis
- Past EBV Infection: The presence of EBV IgG and nuclear antigen IgG with low IgM levels suggests a past infection, as IgG and nuclear antigen IgG typically indicate a resolved infection.
Other Likely Diagnoses
- Chronic EBV Infection: Although less common, chronic EBV infection can present with persistent IgG and nuclear antigen IgG. However, this diagnosis would require additional clinical correlation and testing.
- Reactivated EBV Infection: Reactivation of a past EBV infection can occur, especially in immunocompromised individuals, and may present with elevated IgG and nuclear antigen IgG levels.
Do Not Miss Diagnoses
- Acute EBV Infection with Atypical Serology: Although the IgM level is low, it's essential to consider the possibility of an acute infection with atypical serology, especially if clinical symptoms are consistent with infectious mononucleosis.
- EBV-Associated Malignancy: Certain malignancies, such as Burkitt lymphoma or nasopharyngeal carcinoma, can be associated with EBV. While rare, it's crucial to consider these diagnoses, especially in patients with persistent or unusual EBV serology results.
Rare Diagnoses
- EBV-Associated Autoimmune Disorders: Rare autoimmune disorders, such as autoimmune hemolytic anemia or Guillain-Barré syndrome, can be triggered by EBV infection.
- Congenital EBV Infection: Although extremely rare, congenital EBV infection can occur, and serology results may be atypical. This diagnosis would require additional testing and clinical correlation.