Clinical and laboratory features of infectious mononucleosis depending on the etiological factor in children

Abstract

The article contains the results of observations in 54 children aged 1 to 6 years with infectious mononucleosis. The evaluated of clinical and laboratory data with consideration of the etiological factor of the disease. Depending on the etiology there are 3 groups of patients: 18 with EBV-associated IM, 18 with CMV IM and 18 with mixed etiology mononucleosis (EBV + CMV). All children received antibiotic therapy (cephalosporin of third generation), immunostimulatory drugs, in a dosage of age (recombinant interferon Alfa-2b) and symptomatic treatment. Verification of pathogens was carried out by enzyme-linked immunosorbent assay, were determined separately specific immunoglobulins M and G antibodies to EBV antigens and CMV. Disease in all children was accompanied by fever, tonsillitis, lymphadenopathy, enlarged liver and spleen. A laboratory study of characteristics was carried out at the time of admission and on day 11 of hospitalization. Intoxication with EBV IM were significantly more common than with CMV IM (p = 0,018). The pasty face was noted when mixed IM significantly more frequently than when monoethylamine versions (in comparison with EBV-IM p = 0,03, with CMV IM - p = 0,001). Splenomegaly in EBV + CMV IM more often met in comparison with EBV-IM (p = 0,01) and CMV- IM (p = 0,02). More significant levels of neutropenia and limfomonotsitozis occurred during the EBV-IM. Leukocytosis and increased ESR were more pronounced with CMV IM. Indicators of aminotransferases increased more significantly if EBV IM + CMV IM (in comparison with EBV IM p = 0,04, with CMV IM p = 0,05). On 11th day of hospitalization when the EBV IM in comparison with CMV IM remained more pronounced neutropenia and monocytosis (p = 0,04 and p = 0,05 respectively), nonspecific changes in laboratory indicators (leucocytosis, increased erythrocyte sedimentation rate) - CMV IM (p = 0,05 and p = 0,04 respectively).