Clinical and laboratory features of infectious mononucleosis caused by the Epstein-Barr virus

Abstract

Aim. To study the clinical and laboratory characteristics of patients with infectious mononucleosis caused by the Epstein-Barr virus. Methods. In infectious hospital under observation there were 108 patients aged from 11 months to 31 years with a laboratory confirmed diagnosis of «infectious mononucleosis caused by the Epstein-Barr virus». Standard laboratory tests for blood serum immunoglobulin M to the capsid protein of Epstein-Barr virus, immunoglobulin class G proteins to early Epstein-Barr virus and the index of their avidity by ELISA were carried out. Tests for other infections were conducted if it is required. Results. Patients dominated by children aged 1-7 years - 73.1%. Adult patients was 1.8% (2 patients). Only 4.6% of the patients were sent to the hospital with a diagnosis of «infectious mononucleosis» or suspected of having the disease. The typical clinical picture of infectious mononucleosis was observed in 75% of cases, atypical - in 25%. Mononuclear cells in peripheral blood were found in less than half of the patients (44.4%), in 53.1% of cases with typical and in 18.5% of cases with atypical clinic. In the remaining patients, the diagnosis of infectious mononucleosis was verified by ELISA. In 90.4% of the cases the disease was in the moderate, and in 9.6% - in the severe form. Conclusion. The high frequency of atypical course of infectious mononucleosis caused by the Epstein-Barr virus justifies the need to include it into differential diagnosis process in case of unclear infectious disease, to identify the antibodies to the Epstein-Barr virus proteins, (immunoglobulin M and G) and the index of avidity antibodies (immunoglobulin G).