Brief Answer: It’s a Systemic one, EBV least likely, Seek Rheumo Detailed Answer: Hello Sir! I am Dr S Khan and I will answer your queries. Your worries for EBV are extra biased. What you think of Epstein Barr might not be that at all. The pain in the left upper quadrants of abdomen involves might possibly be your gastro Intestinal tract. As splenomegaly (Enlarged spleen) associated with EBV is mostly painless and there is just a dragging sensation. But low platelets counts show either platelets are destroyed by spleen or not getting produced enough , as you bone marrow is awaited that will confirm all that where is this going. Now your numbness and neurological complaints due to Vit 12 deficiencies and that deficiency further confirms my suspicion of you GIT as stomach is responsible for B12 absorption from Gut and that pain indicates you have gastritis or some other Gastro intestinal manifestations. Now with the multi organ involvements, fatigue, neurological manifestations like numbness etc, Oral cavity lesions Recurrent Aphthous ulcers etc, Gastric discomforts, abdominal crampings, Arthralgias, Hormonal Imbalances. And more confirming and nailing it BY the ANA result which is positive. And the confirming dermatologic manifestation which is more Likely with behcet's. So sorry to say friend but it looks like Systemic disease. Needs a good rheumatologist. So dear, what you worry for is not to worry for but you have a suspected multi organs involvement systemic disease like Lupus, or behcet's or some other systemic manifestation. So my Advice, follow the trail of this positive ANA test with some further work up like Anti Double stranded DNA, Anti XXXXXXX Antibodies, and see where it leads you to. All you need to do is find a very good rheumatologist for you and let him decide what is best for you. Now let’s suppose its EBV which is least likely. Then you need nothing to worry about. Just rest and avoiding strenuous contact sports to avoid splenic lacerations as EBV infections are self-resolving and vanishes in a month or two. Good Luck and take some very good care of yourself. If you have any more queries for me please feel free to ask otherwise I request you to kindly close the discussion and rate the answer as per your experience. May the odds be ever in your favor. Regards Dr. S Khan

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Brief Answer: DO as directed and seek help. Detailed Answer: hello again Friend! As i mentioned the odds for EBV are very unlikely. and with multi organ involvement i definitely suspect the Systemic disease Either lupus or Behcet's. Any how i already mentioned the modus operandi for your management. You should consult with your rheumatologist and let him help to reach the diagnosis. ANA already came positive, Now is the time to specify that By Anti Double stranded DNA and Anti XXXXXXX antibodies, I mentioned all that in detail in my above answer. And for your constantly low platelets, Seek haematologist opinion. They will order some work up to sort out the Thrombocytopenia aetiology and then treat you accordingly for that. But platelets above 50 thousand are not that alarming though should be considered for work up and you already have bone marrow result awaited. things will start to make sense once the reports are arrived. And regarding PCR non detected, yes that is conclusive. You are officially HIV free. You need to stop worrying for something you don't have and seek help for something you might have. Follow my lead do as directed and save the trouble for yourself. My best wishes will join you where ever you go. Seeking Rheumatologist's help would be a good start. Keep asking if some queries left, Otherwise don't forget to close the discussion please.And keep be updated about your progress. Cause my patient is my family May the odds be ever in your favour. Cordial wishes and luck Dr. S Khan

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Brief Answer: previous EBV evidence of serology,need consult Detailed Answer: Hello there again! Thank you for reaching to me. I want you to know that The result positivity might likely be due to previous EBV infection as Most adults (approximately 90%) show serological evidence of previous EBV infection. some of your symptoms are not explained by simple EBV Infectious mononucleosis and they would need a further work up. 1) Yes EBV is an agent/ virus and Infectious Mononucleosis is the result of that.It is also called kissing disease as it is common in young sexually active adults. 2) As you had these symptoms for two years which usually are self resolving in maximum 2 months so yes the odds are high for complications like lymphoproliferative disorder , or acalculous cholecystitis, or anicteric hepatitis.and all these symptoms can be explained then and that would need work up to testify. 3) Greater than 5 antibodies indicate the serum titres of the antibodies in the system, Usually the are qualitative described like +ive or ++ive etc. But as i said earlier you previously had Infectious Mono so this titre might be the previous illness serological evidence as 90 % adults have that previous evidence of serology with n current EBV. needs work up and a good haematologist to sort out. 4)Whether you be contagious or not depends on whether you have that or not. If the serology evidence proved to be of current EBV then yes your oral and genital secretions will carry the infection. But blood id least likely to. 5) Now i suggest that you seek the help of a haematologist and rheumatologist and gastroenterologist. for explaining these barrage of symptoms as even if it EBV it should have just low platelets, a bigger spleen and sore sore throat with all to advise is rest and avoid only complication of splenic rupture.And maintenance of airways as tonsillar enlargement is extreme in these cases. But Your symptoms are more so need a consult with Them. and stop apologising it was pleasure to answer and stop worrying even if its mono it will self resolve and your doctors will decide what medication to be used usually there are not any except some steroids or antivirals. And i will be here if you need me. Good Luck and take some very good care of yourself. Don't forget to close the discussion and rate the answer as per your experience. Regards Dr. S Khan

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