Table 2: Common characteristics of infectious mononucleosis in elderly patients in comparison to younger patients.

Symptoms and signs
 Prolonged fevers
 Generalized lymphadenopathy
 Rarely neurological symptoms
Laboratory tests
 Lack of lymphocytosis
 Heterophile-negative antibody test (increases with age)
 Significant hyperbilirubinemia
 Elevation in liver function tests
 Positive EBV serology
 Protracted duration of illness
 Prolonged hospitalizations
Common workup
 Blood tests including serologies
 Lymph nodes/liver biopsies
 Bone marrow aspiration and biopsies
 Imaging studies including MRI/CT scans

ERCP: endoscopic retrograde cholangiopancreatography. References: Horwitz et al., 1983 [3], and Axelrod and Finestone, 1990 [1].