The Epstein-Barr virus (EBV) antibody titer was examined in 22 children whose atypical mononuclear cells appeared in the peripheral blood smear. Paul-Bunnell and mononucleosis tests were negative in all these children, but antibodies to EBV were demonstrated in 21 of them. Only five children in a control group of 27 had antibodies to EBV. We conclude that the presence of EBV antibodies with a rising titer supports a diagnosis of infectious mononucleosis. It is of particular importance in children under 1 year of age in whom the finding of atypical mononuclear cells in the absence of positive Paul-Bunnell and mononucleosis tests shows a strong correlation with EBV antibody titer. This finding frequently occurs in the absence of typical clinical features of infectious mononucleosis.

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