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Acute infectious mononucleosis A047
Current RMA Instruments:
|Reasonable Hypothesis SOP||3 of 2012|
|Balance of Probabilities SOP||4 of 2012|
Changes from Previous Instruments:
- ICD-9-CM Codes: 075
- ICD-10-AM Codes: B27.0
Is specific diagnostic evidence required to apply the SOP? Yes
Laboratory evidence of recently acquired Epstein-Barr virus infection (see comments), plus evidence of a concurrent clinical illness compatible with acute Epstein-Barr virus infection.
Are there sub-factors that require specific information? No.
Additional diagnoses covered by SOP
- Glandular fever (but see conditions not covered)
- Acute infectious mononucleosis - resolved (see comments)
- Symptomatic Epstein-Barr virus infection
Conditions not covered by SOP
- Asymptomatic Epstein-Barr virus infection - N.I.F.
- Chronic fatigue syndrome, ICD code 780.7
- Glandular fever due to cytomegalovirus infection, ICD code 078.5
- Infectious mononucleosis due to cytomegalovirus infection, ICD code 078.5
If, after applying the above information, you are unable to confirm the diagnosis, you should then:
- seek medical officer advice about further investigation, or;
- re-encode the condition, if appropriate.
The following investigations may be useful in establishing the diagnosis.
- A report from a physician or general practitioner, describing the symptoms and signs of the relevant clinical illness, as well as details of Epstein-Barr virus serology.
A claim for previously symptomatic Epstein-Barr virus infection, that has now resolved, can be diagnosed as "acute infectious mononucleosis - resolved" and determined using the SOP.
Epstein-Barr virus serology – a primary EBV infection is indicated if IgM antibody to the viral capsid antigen is present and antibody to EBV nuclear antigen (EBNA) is absent. A rising or high IgG antibody to the viral capsid antigen and negative antibody to EBNA after at least 4 weeks of illness is also strongly suggestive of primary infection. In addition, 80% of patients with active EBV infection produce antibody to early antigen.