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A diagnostic dilemma arises when the patient has clinical and laboratory features of IM, but is both heterophile negative and seronegative for IM, as illustrated in this case presentation. To avoid missed diagnoses of IM, misdiagnosis of mononucleosis-like illnesses and unnecessary testing, knowledge of test characteristics and the evolving course of EBV serologies is important to assure and inform both the physician and the patient.<\/jats:p>","DOI":"10.1136\/bcr-2022-250081","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T11:02:48Z","timestamp":1683111768000},"page":"e250081","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Fever with atypical lymphocytosis: pearls and pitfalls in Epstein-Barr virus serology"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3839-8654","authenticated-orcid":false,"given":"Jia Wei","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, 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