A patient with lymphadenopathy, fever, and discomfort reports having had adenoid surgery in childhood. What diagnostic test should be performed?

The clinical presentation of lymphadenopathy (enlarged lymph nodes), fever, pharyngitis, and fatigue in an adolescent or young adult is classic for infectious mononucleosis (mono), caused by Epstein-Barr virus (EBV). The Monospot test detects heterophile antibodies produced in response to EBV infection. It is rapid (results in minutes) and has sensitivity of approximately 85% and specificity of 97%. A positive Monospot confirms the diagnosis. In dental practice, mononucleosis is relevant because patients may have thrombocytopenia (reduced platelets) and hepatosplenomegaly that affect treatment planning. Splenomegaly (enlarged spleen) is present in 50% of mono cases and is a contraindication for contact sports.