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EPIC CODE: MONOS Infectious Mononucleosis, Rapid Test, Serum

Reporting Name

Infectious Mono Test, S

Useful For

Diagnosis of Epstein-Barr virus mononucleosis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type


Specimen Required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values


Reference values apply to all ages.

Day(s) Performed

Monday through Sunday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
MONOS Infectious Mono Test, S 5213-4


Result ID Test Result Name Result LOINC Value
MONOS Infectious Mono Test, S 5213-4

Clinical Information

Infectious mononucleosis (IM) is a viral illness that involves reticuloendothelial tissue and is generally limited to children and young adults. IM is most commonly caused by Epstein-Barr virus. The disease is characterized by fever, sore throat, lymphadenopathy, headache, and fatigue and, on a symptomatic basis, may be confused with other diseases. Detectable levels of unique heterophile antibodies are produced in patients with IM.


Detectable levels of the infectious mononucleosis heterophile antibody can usually be expected to occur between the sixth and tenth day following the onset of symptoms. The level usually increases through the second or third week of illness and, thereafter, can be expected to persist, gradually declining over a 12-month period.


Approximately 10% of patients with infectious mononucleosis (IM) will have no heterophile antibody and may require Epstein-Barr virus antibody tests to confirm the diagnosis.


False-negative results have been reported. Some of these may represent cases of IM that remain persistently seronegative for the IM heterophile antibody. However, some false-negative results have been shown to be due to a delayed IM heterophile antibody response.


IM heterophile antibody titers have been shown to persist in some cases for months to years after clinical symptoms have subsided. Conversely, IM heterophile antibodies have been detected prior to the onset of clinical symptoms. Thus, caution should be exercised in the interpretation of test results.


The IM heterophile antibody has been associated with several diseases other than IM. These include leukemia, Burkitt lymphoma, pancreatic carcinoma, viral hepatitis, cytomegalovirus infections, and others. In these cases, it is difficult to disprove the possibility of concurrent disease states.


Some segments of the population do not produce detectable heterophile antibodies, eg, approximately 50% of children under 4 years of age and 10% of adolescents.

Clinical Reference

Johannsen EC, Kaye KM: Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:1872-1890

Method Description

The Remel Mono-Lex System is a latex agglutination test for the detection of infectious mononucleosis (IM) heterophile antibody. Latex particles are sensitized with a bovine red cell-mononucleosis antigen. When agglutination is observed, a diagnosis of IM is highly probable. The presence of IM antibody in serum at detectable levels will interact with the sensitized particles to produce visible aggregation, which is a positive result.(Package insert: MONO-LEX System. Remel Inc; 07/2020)

Report Available

Same day/1 to 2 days

Specimen Retention Time

14 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject

NY State Approved


Method Name



If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.