Lymphadenopathy as a marker of the primary form of Epstein-Barr of viral infection, recurrent respiratory diseases and adenovirus infection in children

Abstract

Lymphadenopathy is one of the leading manifestations of an overt or latent infectious process in viral diseases, and in their differential diagnosis of diseases it is considered as one of the leading markers.Objective ‒ to determine the importance of lymphadenopathy in the differential diagnosis of the primary form of the Epstein-Barr viral infection, recurrent respiratory diseases and adenovirus infection in children and adolescents.336 children and adolescents aged 7 to 17 years inclusive with viral infections and lymphadenopathy were examined: 93 patients with the primary form of Epstein-Barr viral infection (EBVI), 167 patients with recurrent respiratory diseases (RRD), 76 patients with tonsillar adenoviral infections (ADVI), which underwent ultrasound examination of the submandibular, anterior and posterior cervical, inguinal and mesenteric lymph nodes.Lymphadenopathy of various localization was detected in all patients with the primary form of EBVI, RRD and ADVI. A detailed analysis of the topographic features of lymphadenopathy in the context of the timing of its regression showed that in children and adolescents with the primary form of EBVI, the disease began with a simultaneous enlargement of the lymph nodes of all groups, and the increase in the posterior cervical and submandibular lymph nodes did not correspond to the objective state of the oropharyngeal lesion. In RRD, lymphadenopathy of the cervical region was most often observed, and in ADVI, moderate generalized lymphadenopathy was observed.Lymphadenopathy in EBVI is generally characterized by a large diameter (2.7 ± 0.06 cm) of the lymph nodes; whereas in RRD and ADVI, lymph nodes of small (0.5 ± 0.03 cm) and medium (0.6 ± 0.1 cm) diameters prevailed. Morphological changes in the lymph nodes in lymphadenopathy in the primary form of Epstein-Barr viral infection, recurrent respiratory diseases and adenovirus infection are manifested by a heterogeneous structure and different echogenicity of the stroma, which can be taken into account as a marker at the stages of early and differential diagnosis of the listed viral infections.