Acute EBV mononucleosis in children of various ages hospitalized in the infectious hospital of the St. Petersburg State Pediatric Medical University in 2017–2020

Abstract

BACKGROUND: The problem of acute EBV-mononucleosis is one of the most urgent in pediatrics. In the structure of the incidence of infectious mononucleosis, the proportion of the child population is 70–80%, children 4–8 years old are more often ill. Maternal antibodies protect an infant only in the first months of life, primary infection may occur at 3 months of age, and a manifest form of acute EBV-mononucleosis may develop at 6 months of age. AIM: The aim of the study was to analyze peculiarities of acute EBV-mononucleosis in children of different ages hospitalized in the infectious diseases hospital of the Saint Petersburg State Pediatric Medical University. MATERIALS AND METHODS: The article presents data on 376 children aged 1 to 18 years with a diagnosis of Acute EBV mononucleosis, hospitalized in the period 2017–2020. In the infectious diseases department No. 1 of Saint Petersburg State Medical University. Etiological interpretation was carried out using ELISA (determination of IgM to VCA in the blood) and detection of EBV DNA in the blood by PCR. RESULTS: In 89.6% of cases, the disease was of moderate severity. Acute onset of the disease was noted in 69.7% of cases, more often in children from 1 to 10 years old. Intoxication syndrome was observed with the same frequency in all age groups. Febrile fever was observed in 96.0% of patients. The syndrome of acute tonsillitis, lymphadenitis was detected in all patients. The phenomena of adenoiditis and hepatomegaly were more pronounced in younger children. Splenomegaly was recorded in 74.5% of cases, more often than hepatomegaly. Cytolysis syndrome was observed in every second child. In older age groups, there was a higher level of hyperenzymemia and a pronounced mononuclear reaction in the hemogram. CONCLUSION: All the analyzed patients had a typical clinical picture of acute EBV mononucleosis with a characteristic syndrome complex. In most cases, the disease was of moderate severity, severe severity was recorded in 8.2% — mainly in older children. Involvement of the liver and spleen in the pathological process simultaneously took place in every second patient. In older age groups, there was a higher level of hyperfermentemia and a pronounced mononuclear reaction in the hemogram.