How common is chronic infectious mononucleosis (mono) and how is it differentiated from chronic fatigue syndrome (CFS)?

Updated: Sep 20, 2018
  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Chronic infectious mononucleosis is rare and occurs in those with immunologic abnormalities. Such patients present with fever, lymphadenopathy, persistently elevated serum transaminases, and pancytopenia. Eye or neurologic abnormalities may also be present. Importantly, patients with CFS have none of these findings. Patients with acute EBV infection do not have pancytopenia, and their clinical presentation rapidly resolves. Chronic infectious mononucleosis is a diagnosis that should be made rarely and carefully. Commonly, patients and physicians equate increased EBV immunoglobulin G (IgG) VCA antibody titers with chronic infectious mononucleosis or CFS because more than 90% of the population has increased EBV IgG VCA antibodies. The associated findings of fatigue are coincidental and are not related causally.


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