INTERPRETATION OF HEMATOLOGIC AND SERO- LOGIC FINDINGS IN THE DIAGNOSIS OF INFECTIOUS MONONUCLEOSIS*

ARTICLES stressing certain rare and preternatural manifestations of infec-tious mononucleosis continue to occupy a prominent place in the literature of this disease. It is noteworthy that atypical clinical features have not been the only atypical findings in many of these cases. I have been puzzled by cases that have failed to show a lymphocytosis. For example, although heterophil tests were positive in a case recently reported in a four year old girl with severe central nervous system involvement, other findings in-cluded a neutrophilia of 93%, no abnormal lymphocytes at any time during the illness, and none of the usual clinical manifestations of infectious mononucleosis.1 In my own experience the differential counts of patients with this dis-ease have regularly been characterized by a lymphocytosis. In all cases the diagnosis was further substantiated by high atypical lymphocyte counts and by heterophil antibody titers of 1:56 or greater, as well as by clinical manifestations common to infectious mononucleosis. These observation