Beef, ox, and horse red blood cells are also agglutinated by the heterophil antibodies found in the serum of mononucleosis patients, but these heterophil antibodies do not bind to guinea pig kidney antigen extracts. These properties of mononucleosis heterophil antibodies distinguish them from the naturally occurring Forsmann heterophil antibodies and from the heterophil antibodies found in serum sickness and other conditions. Under 4 years of age the test is considerably less reliable and frequently negative. Other EBV serologic assays are available. The accompanying graph shows the typical time course of the presence of various EBV antibodies.
Supportive therapy is usually all that is required in uncomplicated infectious mononucleosis.
A period of 21 days is considered critical for risk of splenic rupture. During this time, the patient should avoid risk of abdominal trauma, increased intra- abdominal pressure and remain under medical surveillance. The patient should typically not be allowed to return to contact sports until there is complete resolution of splenomegaly documented either by physical exam or nuclear medicine scans. Corticosteriods have been used therapeutically. Most authors reserve corticosteroids for specific indications including acute and severe hemolytic anemia, rapidly progressive or hemorrhaging thrombocytopenic purpura and compromised airway.