Once acquired, Epstein-Barr virus (EBV), a latent virus, remains in the body for what appears to be the lifetime of the human host. Circumstantial data suggest EBV is involved in clinical disease including malignancies far more often than previously recognized. A serologic test for early antigen (EA) is more specific for diagnosing active EBV disease than the monospot or heterophile test. A case study of active Epstein-Barr infection is reported showing persistently elevated early antigen titers prior to and following malignant transformation.