C is the correct answer. Why?
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A Complete blood count
B EBV-specific antibodies
C Heterophile antibodies
D Polymerase chain reaction
Explanation
Epstein-Barr virus (EBV) is implicated in a variety of human illnesses, and it is the causative agent of heterophile-positive infectious mononucleosis. EBV infection requires close contact for transmission, and the infection is usually contracted from an asymptomatic individual who sheds the virus. Patients will often present with fever,lymphadenopathy (posterior chain lymphadenopathy), pharyngitis, and tonsillar exudates. Splenomegaly occurs in more than half of patients. Severe fatigue is a prominent feature and can persist for months. Classically, patients may develop a morbilliform rash after being treated with ampicillin or amoxicillin for suspected streptococcal pharyngitis. The monospot test identifies heterophile antibodies and is the initial test of choice if one is to be performed. Treatment consists of rest and analgesia as the mainstays of therapy. Corticosteroids should only be used in patients with severe disease, such as upper airway obstruction, neurologic disease, or hemolytic anemia, as their use may increase complications. Patients should be advised to refrain from all contact sports for a minimum of 3 weeks after the illness to avoid splenic injury.
Although a complete blood count (A) may be helpful in increasing suspicion for the diagnosis as there will be a predominance of lymphocytes present on the differential, it will not provide a diagnosis. The EBV-specific antibody (B)test evaluates for antibodies created by the infection. It is highly sensitive and specific for the diagnosis, however, it is considered a second-line test and should be used in cases of prolonged illness or for those who do not fit classic diagnostic criteria. Polymerase chain reaction (D) identifies viral DNA that can be detected in the blood in up to 70 percent of patients at the time of symptom onset and 90 percent after 2 weeks of onset. Similar to EBV-specific antibodies, this test should only be used in cases of prolonged illness or for those who do not fit the classic diagnostic criteria.