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Mononucleosis-like syndrome is a collection of symptoms including fatigue, fever, sore throat, and swollen lymph nodes that resemble classic infectious mononucleosis. It is caused by viruses other than Epstein-Barr virus (EBV), most commonly cytomegalovirus (CMV), which produces identical symptoms. The Cytomegalovirus (CMV) Antibodies, IgM, Quantitative test is the most important test for diagnosis when symptoms suggest mononucleosis but EBV testing is negative.
Mononucleosis-like syndrome is caused by viruses other than Epstein-Barr virus (EBV), with cytomegalovirus (CMV) being the most common culprit. While classic mononucleosis results from EBV infection, CMV and other viruses like toxoplasma and human herpesvirus-6 can produce identical symptoms. These viruses infect white blood cells and lymphatic tissue, triggering the characteristic fatigue, fever, sore throat, and swollen lymph nodes that define the syndrome.
The Cytomegalovirus (CMV) Antibodies, IgM, Quantitative test is the most important test for mononucleosis-like syndrome because it detects active CMV infection, the leading non-EBV cause of these symptoms. This blood test measures IgM antibodies that appear during recent or active CMV infection, helping differentiate CMV mononucleosis from EBV mononucleosis when standard mono tests are negative. Your healthcare provider may also order EBV antibody testing and a complete blood count (CBC) to rule out other causes and assess your immune response.
You should get tested if you experience persistent fatigue, fever, sore throat, and swollen lymph nodes lasting more than a week, especially if a standard mononucleosis test comes back negative. Testing is particularly important if you have extreme exhaustion that interferes with daily activities, enlarged spleen causing abdominal discomfort, or if you are pregnant or immunocompromised, as CMV infection requires different monitoring. Early diagnosis helps your healthcare provider create an appropriate management plan and rule out other serious conditions.
What this means
Your testosterone levels are slightly below the optimal range. While this is not necessarily cause for concern, it may contribute to occasional fatigue, reduced motivation, or lower muscle mass over time.
Recommended actions
Increase resistance or strength training
Prioritize 7–8 hours of quality sleep per night, try to reduce stress
Include more zinc- and magnesium-rich foods (like shellfish, beef, pumpkin seeds, spinach)
Consider retesting in 3–6 months
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