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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56838
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Ive been running a low grade fever for almost 3 months now.

Customer Question

I've been running a low grade fever for almost 3 months now. My doc did all kinds of labs (including autoimmune labs which were negative) and all of my CBC's have come back normal for the most part. He FINALLY tested me for Mono 2 weeks ago after being sick all this time. When the test came back, they told me I have Mono, but then when I asked if it was active Mono, they said they didn't think so. I then faxed my results to a family friend (an ER doc) and he said it looked like I had it, but might be in the convalescence phase right now but he wasn't 100% sure as he's not used to reading EBV lab results. Well I'm still running a low grade fever and feel yucky. From my results below, do you think that Mono is what has had me down for the last 3 months? I've felt extremely tired, achy, but have NOT had the sore throat and no swollen lymph nodes that I could tell the entire time. I'm being told to wait this out, but don't want to wait if it's not Mono and could be something else- it's driving me crazy wondering!!! Also, do you still run a fever in the convalescence phase (I am)?
Here are my labs:

EBV Panel Interpretive Table:
CLINICAL STAGE VCA-IgG VCA-IgM Early AG EBNA
---------------------------------------------------------------------------------------------------
Never infected - - - -
Acute Infection + + +/- -
Convalescence + +/- + +/-
Recent Past Infect + - +/- +
Remote Past Infect + - - +
Chronic Infect + - + +/-

EBV Early AG IgG <5.0 (Normal range 600.0 (High) (Normal range <18.0)

EBV VCA IgG 71.7 (High) (Normal range <18.0)

EBV VAC IgM <10.0 (Normal range <36.0)


Comprehensive Metabloic Panel labs all normal except:
Albumin 5.2 (H)
Lymphocytes 13 (L)
Neutrophils 82 (H)
Hemaocrit 45.1 (H)
WBC 9.8- Normal

Other testing I've had is an EGD for mild upper left ABD pain below ribs- came back normal but it feels like it's in my rib bones themselves for some reason
H Pylori testing- negative
ABD US- normal
Sinus testing with CT- no infection
Chest Xray- normal

What I want to know:
1) Does it look like Mono was most likely my problem this whole time?
2) Should I wait this out even though I'm still running a low grade fever each day?
3) Should I have anything else tested?
4) Can you still run a fever in the convalescence period with Mono or EBV?
5) My first doc put me on Cipro 500mg BID bec from my CMP he said I had a bacterial infection, but the family friend doc said he didn't see any indication for antibiotic use from my labs. Do you see a reason for the antibiotic use from the labs I've listed?

Thank you :)
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 1 year ago.
Hello from JA
This is not acute mono
IgM is negative, so you are beyond any acute stage.

Is this all the results for mono you have?
Customer: replied 1 year ago.

Yes, those are all of the results.


So, if I'm still running a low grade fever, would you think something else is going on?

Customer: replied 1 year ago.

I'm sorry, I forgot to add that the EBV Nuclear Antigen IgG was >600 (high)

Expert:  Dr. Thomas, MD replied 1 year ago.
OK
And your early antigen is unclear
YOu have it as positive and negative
Customer: replied 1 year ago.

Sorry, the results showed up somewhat skewed:


 


EBV Early AG IgG <5.0


 


EBV Nuclear Antigen IgG >600 (high)


 


EBV VCA IgG 71.7 (high)


 


EBV VCA IgM <10.0

Expert:  Dr. Thomas, MD replied 1 year ago.
OK
This is old mono
You dont have active mono at this point
Is this what you are asking?
Customer: replied 1 year ago.

So would it be safe to say that's probably not what's causing my low grade fever for the last 3 months?

 

Would you suggest additional testing? If so, what would you check next?

Expert:  Dr. Thomas, MD replied 1 year ago.
It depends when you had the mono.
IgM can dissapear after 6 weeks.
So if you are getting better now it still could be the mono
But you never had a monospot test, so hard to say
What symptoms remain?
Customer: replied 1 year ago.

I'm still running a low grade fever each day (99.5-100). I feel tired and achy all the time. I have rib pain on my left side- it feels like bone pain though.

Expert:  Dr. Thomas, MD replied 1 year ago.
OK
You need to get a specific test called early antigen D antibody.
If this is positive you might still be having mono symptoms.

Otherwise it is not related to mono.

Let me know if you have further questions. Just use reply if you are not done.

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Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56838
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.
Is that different than the EBV early AG IgG?
Expert:  Dr. Thomas, MD replied 1 year ago.
Yes it is
It has to be special ordered.

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