The diagnosis is suggested by the clinical features. The most frequently used serologic test is the EBV-specific heterophile antibody test (the "monospot test," "mononucleosis spot test," or Paul-Bunnell test), which gives a positive result (2). Other abnormal laboratory findings include elevated white blood cell (WBC) count ranging from 1.0 x 109/L to 1.5 x 109/L; of these WBCs, 50% or more are "atypical" lymphocytes with oval, kidney-shaped nuclei and vacuolated cytoplasm. Thrombocytopenia is common, and levels of hepatic enzymes may be elevated.
Cytomegalovirus (CMV) can produce symptoms that mimic those of infectious mononucleosis, but give a negative result when subjected to the heterophile antibody test. The diagnosis must be made by isolating the CMV virus. CMV-type mononucleosis usually has both slower onset and slower resolution. Most infected patients recover without sequelae.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.