False positivity of monospot test in an immunocompetent elderly woman with acute cytomegalovirus infection.
A 75-year-old woman presented with altered mental status, septic picture, and influenza-like symptoms. Initial investigations revealed atypical lymphocytosis, thrombocytopenia, elevated liver enzymes, and a positive monospot test result. Further investigation showed the Epstein-Barr virus viral capsid antibody IgM/IgG and Epstein-Barr virus DNA by polymerase chain reaction to be negative; however, interestingly her cytomegalovirus (CMV) IgM and IgG were positive, suggesting that her mononucleosis-like syndrome was due to acute CMV infection. Herein, we report the first case of a heterophile-positive mononucleosis syndrome caused by acute CMV infection in an elderly immunocompetent woman. This case conveys that monospot test can yield false-positive result in the setting of acute CMV infection.
Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY. Electronic address: natthamcharoen@gmail.com.
Natanong
N
Thamcharoen
Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY.
Suthanya
S
Sornprom
Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA.
Nitipong
N
Permpalung
Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY.
Charles L
CL
Hyman
D000208:Acute Disease; D000368:Aged; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000175:diagnosis; D012698:Serologic Tests / Q000379:methods*