Age clinical and laboratory features of primary Epstein-Barr viral infection in children

Abstract

Aim: to delineate the clinical presentation and laboratory profile of primary Epstein-Barr viral infection (EBVI) in children.Materials and methods. A retrospective study was conducted on the demographic, clinical and laboratory data of 104 children with infectious mononucleosis due to Epstein–Barr virus (EBV) infection in children. The analysis included serologically confirmed cases – the presence of IgM to the capsid EBV antigen (VCA IgM) with the absence of antibodies to the nuclear EBV antigen (EBNA IgG).Results. The mean age of children was 4.0 (2.6; 9.0) years. The maximum hospital morbidity for infectious mononucleosis was observed in children from 2 to 5 years – 35.6 % whereas in patients from 12 years to 17 years – 19.2 %. The mean peak temperature was higher in young children. The rate of the cervical lymphadenopathy was significantly higher in adolescents compared with infants (P < 0.001). Tonsillitis syndrome was more commonly seen in children aged from 2 to 11 years (P < 0.05). Rash was detected in 22.1 % (n = 23) of children. The presence of petechiae was more common in older children. Hepatosplenomegaly syndrome was reported in 50 % of older children and only in 8.7 % of infants. Cytolytic syndrome was reported in 54.2 % of patients from 6 to 11 years and in 100 % of the adolescents from 12 to 17 years, although in infants it was only in 34.8 % (P < 0.001). Atypical mononuclear cells were detected in 8.7% of early age children and in 24.3–37.5 % of older children.Conclusions. Age differences were noted in clinical findings for cervical lymphadenopathy and splenomegaly, which were less common in children of the first 2 years. A significant difference in the incidence of hepatitis was found: with increasing age of the patient, the mean level of ALT increased significantly and gradually.