Nausea, fever, and weight loss
The patient’s monospot test was positive, but the clinical picture didn’t fully match infectious mononucleosis. We dug further.
The cause of the misdirect? We believe the monospot test was either a false-positive result or a persistent positive result from an infection earlier in the year. (False-positives occur rarely, but have been reported in patients with leukemia, lymphoma, pancreatic cancer, systemic lupus erythematosus, HIV infection, and rubella.6)
Our patient had an uneventful recovery at the skilled nursing facility and returned home after the completion of his antibiotics. The patient was counseled to enter a drug treatment program, but at the time of discharge from the skilled nursing facility, had not made the arrangements.
CORRESPONDENCE
Christopher Bernheisel, MD, Director, Family Medicine Inpatient Service, The University of Cincinnati, 2123 Auburn Avenue, Suite 340, Cincinnati, OH 45219; bernheiseljfp@me.com
