Monospot test (heterophil test). This quick screening
test detects a type of antibody (heterophil antibody) that forms during certain infections.
A sample of blood is placed on a microscope slide and mixed with other substances.
If heterophil antibodies are present, the blood clumps (agglutinates). This result
usually indicates a mono infection. Monospot testing can usually detect antibodies
2 to 9 weeks after a person is infected. It typically is not used to diagnose mono
that started more than 6 months earlier.
EBV antibody test. For this
test, a sample of blood is mixed with a substance that attaches to antibodies against
EBV. A series of tests can detect different types of antibodies to help determine
whether you were infected recently or sometime in the past.
Why It Is Done
monospot test is done to help diagnose a recent
Epstein-Barr virus (EBV) antibody testing is also done to help
diagnose mono. The EBV antibody test can help determine whether you have ever been
infected with the virus and whether the infection has been recent.
testing is usually done when you have symptoms of infectious mononucleosis and a monospot
test result is negative. EBV antibody testing may also be done to check for antibodies
to EBV when a person has a disease or uses medicine that causes problems with the
How To Prepare
No special preparation is required before
having this test.
Talk to your doctor about any concerns you have regarding
the need for the test, its risks, how it will be done, or what the results will mean.
To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).
It Is Done
The monospot test is done on a small sample of blood taken from
your fingertip or from a vein. The Epstein-Barr antibody test is done on a blood sample
taken from your vein.
Blood test from a finger stick
a fingertip sample, the health professional taking the sample will:
your hand with soap and warm water or an alcohol swab.
Massage your hand without
touching the puncture site.
Puncture the skin on the side of your middle or
ring finger with a small instrument called a lancet.
Wipe away the first drop
Place a small tube called a capillary tube on the puncture site
and collect a small amount of blood.
Put a gauze pad or cotton ball over the
puncture site as the tube is removed.
Put pressure on the site and then put
on a bandage.
Blood test from a vein
health professional taking a sample of your blood will:
Wrap an elastic
band around your upper arm to stop the flow of blood. This makes the veins below the
band larger so it is easier to put a needle into the vein.
Clean the needle
site with alcohol.
Put the needle into the vein. More than one needle stick
may be needed.
Attach a tube to the needle to fill it with blood.
the band from your arm when enough blood is collected.
Put a gauze pad or
cotton ball over the needle site as the needle is removed.
Put pressure on
the site and then put on a bandage.
How It Feels
blood sample is taken from a vein in your arm or from your fingertip. You may feel
nothing at all from the needle or lancet, or you may feel a quick sting or pinch.
The elastic band that is wrapped around your upper arm when blood is taken from a
vein may feel tight.
There is very little chance of a problem from
having a blood sample taken from your fingertip or a vein.
You may get
a small bruise at the site. You can lower the chance of bruising by keeping pressure
on the site for several minutes.
In rare cases, the vein may become swollen
after the blood sample is taken. This problem is called phlebitis. A warm compress
can be used several times a day to treat this.
The results of a monospot test are
usually ready within 1 hour.
The blood sample does not form clumps (no heterophil antibodies
sample clumps (heterophil antibodies are detected). If the blood sample clumps, you
probably have mono.
The results of the antibody test to detect Epstein-Barr virus
(EBV) may be reported as positive (antibodies are present) or negative (antibodies
are not present). Or the test results may be reported in titers.
The EBV antibody test can also
detect the type of antibodies (immunoglobulins) present in the blood. The type of
antibody shows whether the infection is recent or old. The antibody IgM is only found
during the active phase of mono. The antibody IgG can be found later, when you are
starting to get better.
The results of an EBV antibody test are usually ready
within 3 days.
The titer is less than 1 to 10 (1:10). A titer of less than
1:10 means that you have never been exposed to EBV.
No IgM against EBV is present.
If IgG is present, it may mean that you have been exposed to EBV in the past.
A titer greater than 1 to 10 (1:10) but less than 1:320
usually means that you have been infected with EBV at some time in the past.
titer of 1:320 or greater means that you have an active EBV infection (mononucleosis).
against EBV is present.
What Affects the
Reasons you may not be able to have the test or why the results may not
be helpful include:
Having an EBV antibody test within the first few weeks
of becoming infected with EBV. This may lead to a false-negative result. If the first test does
not indicate mono but you still have symptoms, the test may be repeated.
infection or disease, such as cytomegalovirus (CMV), leukemia or lymphoma, rubella,
hepatitis, or lupus. Although the symptoms of these infections and diseases are similar
to mono, the monospot test usually will be negative.
Since many people are exposed to Epstein-Barr virus (EBV)
during childhood, most adults have EBV antibodies of a type called IgG. The presence
of the IgG type of antibody does not necessarily mean that you have had a recent infection
Although some people think that the Epstein-Barr virus (EBV) may
be related to myalgic encephalomyelitis/chronic fatigue syndrome
(ME/CFS), experts have found no evidence for this. The monospot test and the EBV antibody
test are not used to diagnose or monitor CFS.
Children, especially those younger
than 2 years, are more likely than adults to have a negative monospot test, even when
they have mono. This is called a false-negative result.
Pagana KD, Pagana
TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis:
Other Works Consulted
CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis:
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory
and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St.
Louis: Mosby Elsevier.
Staff Primary Medical ReviewerE.
Gregory Thompson, MD - Internal Medicine Adam
Husney, MD - Family Medicine Caroline S. Rhoads,
MD - Internal Medicine
Pagana KD, Pagana TJ
(2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis:
This information does not replace the advice of a doctor.
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