Thompson M P
Prim Care. 1986 Dec;13(4):647-55.
Infectious mononucleosis has been known for a long time to be a common infection in young adults. It also infects children. In particular, children under the age of 2 years may not express the illness clinically. Diagnostic criteria vary but in young adults usually include the symptoms of fever, exudative tonsillitis, and cervical lymphadenopathy. Usually, there is a relative and absolute lymphocytosis, with 10 to 20 per cent or greater atypical lymphocytes. Rapid slide tests are accurate and economical and support the diagnosis when positive. False-positive results are known to occur with several other important disease processes; therefore, the clinical presentation and laboratory results must be interpreted in their appropriate context. Quality control is essential even for the rapid slide tests, and experienced examiners are required to review blood smears. The morphology of atypical lymphocytes varies greatly. In addition, morphology interpretation can be hampered by problems in preparation of slides or the holding of blood samples awaiting slide preparation. EBV-specific serodiagnosis has significantly enhanced our ability to study further and differentiate heterophil-negative syndromes that share clinical features with infectious mononucleosis. Acute, past, chronic, and no EBV infection can now be differentiated. Further diagnostic tests for other etiologic agents are necessary when all EBV tests are negative and the clinical situation requires appropriate diagnosis.
长期以来，传染性单核细胞增多症一直被认为是年轻成年人中常见的感染性疾病。它也会感染儿童。特别是2岁以下的儿童可能不会表现出临床症状。诊断标准各不相同，但在年轻成年人中通常包括发热、渗出性扁桃体炎和颈部淋巴结病等症状。通常会出现相对和绝对淋巴细胞增多，其中10%至20%或更多为非典型淋巴细胞。快速玻片试验准确且经济，阳性时可支持诊断。已知在其他几种重要疾病过程中会出现假阳性结果；因此，必须结合适当的背景来解读临床表现和实验室结果。即使是快速玻片试验，质量控制也至关重要，并且需要有经验的检查人员来复查血涂片。非典型淋巴细胞的形态差异很大。此外，玻片制备问题或等待玻片制备时血液样本的保存问题可能会妨碍形态学解读。EB病毒特异性血清学诊断显著提高了我们进一步研究和区分与传染性单核细胞增多症具有共同临床特征的嗜异性抗体阴性综合征的能力。现在可以区分急性、既往、慢性和无EB病毒感染情况。当所有EB病毒检测均为阴性且临床情况需要适当诊断时，有必要对其他病原体进行进一步的诊断检测。
