“Can a pathology report be wrong?”

What happen is that the mononucleosis Titer are still undetectable blood and that’s why maybe is negative. However, how do you know you have mono if you tested negative. Maybe you have another process. The laboratory rarely is wrong and the few occasions that the laboratory was wrong was because of mislabeled of the blood sent to the lab. Thank you.

Yes but it is very rare. Significant diagnoses or unexpected diagnoses should always be seen by more than one pathologist for second opinion/consult.

Sure, but you may not have mono since a lot of things cause similar symptoms. There are more specific tests for mono. See if your doctor will order those, along with investigating other possibilities. Perhaps try another lab? Good luck.

RB Thomas,MD

In short, yes, the test can be negative in the presence of a true mononucleosis infection. How can this happen? The mono spot test relies on detecting particular antibodies in the blood of patients who are infected. For some patients who are are tested in the early or "acute" phase of the disease, the antibody levels can be so high in the blood that they overwhelm the test
and a "false negative" reading results. This is called the "prozone" effect and can occur with other tests involving antibodies as well. If the patient really does look like they mono - and a simple review of a peripheral blood film can provide additional evidence - then the test should be repeated a week or two later, during the "chronic" phase, and a true positive result will be found. Of course, it is always possible that the "negative" result is a "true negative" and there is a different condition causing the illness - like another virus. CMV can mimic mono, clinically.

Yes. Sometimes serological tests fail to detect the presence of an infection, due to many factors. Most important is the timing of the test.