RENEWED interest in the diagnosis of infectious mononulceosis has developed since the introduction of the Paul-Bunnell test in 1932.1 Although a positive heterophile antibody reaction is not essential in making the diagnosis of this disease, the reaction is almost pathognomonic when positive. The early or frequent use of this test may establish a diagnosis when the clinical signs are confusing or before suggestive or diagnostic changes in the white blood cells have occurred; however, it may not be positive during the acute phase of the disease, nor is it necessarily related to the changes in the blood picture. Blood smears and Paul-Bunnell tests may have to be repeated several times before the diagnosis is established. Usually these procedures are not frequently repeated in the management of private patients because of the expense involved. This becomes even more apparent should the patient have a mild form of the disease. It
JOYCE FT. INFECTIOUS MONONUCLEOSIS: A Consideration of the Complications and a Preliminary Report on the Use of Penicillin in This Disease. Arch Intern Med (Chic). 1946;78(1):49–63. doi:10.1001/archinte.1946.00220010059006
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