Clinical characteristics of infectious mononucleosis with Epstein-Barr virus and mycoplasma pneumoniae infection in children

Abstract

Objective To explore the clinical characteristics of infectious mononucleosis (IM) with Epstein-Barr virus (EBV) and mycoplasma pneumoniae (MP) infection in children. Methods Children with IM who were all positive for EBV and hospitalized in our department from January 2008 to July 2015 were included and divided into the EBV+ MP group and the EBV group according to the results of MP.The manifestations, laboratory variables and outcomes were compared in the two groups. Results Of all these 61 cases, 18 children (29.51%) were accompanied with EBV and MP infection.The age of the EBV+ MP group was older than the EBV group [(4.44±2.75) vs (2.90±2.08)years, t=2.401, P=0.02]. Moderate to severe enlarged tonsils, hepatomegaly and complications (especially cough and gastrointestinal symptoms) were more common in the EBV+ MP group than the EBV group with significant differences (remarkable tonsillitis: 88.89 vs 48.84%, hepatomegaly: 55.56 vs 13.95%, complications: 72.22 vs 44.19%; χ2=8.529, 10.719 and 3.999 respectively; P=0.003, 0.001 and 0.046 respectively). The WBC and lymphocyte counts, percentage of abnormal lymphocyte and the levels of glutamyltranspeptidase in the EBV+ MP group were also significantly higher than the EBV group [WBC counts: (18.17±7.17)×109/L vs (13.70±7.12)×109/L], lymphocyte counts: (11.61±6.04)×109/L vs (7.65±4.82)×109/L, abnormal lymphocyte proportion: (20.69±13.03)% vs (13.00±11.20)%, serum glutamyltranspeptidase: (99.41±91.20)U/L vs (47.95±69.22)U/L; t=2.231, 2.716, 2.215 and 2.239 respectively; P=0.029, 0.009, 0.031 and 0.029 respectively). But the average hospital stay and the recovery time of manifestations showed no significant differences in the two groups (P>0.05). Conclusion IM children with EBV and MP infection have more cases with moderate to severe enlarged tonsils, hepatomegaly and complications, moreover present higher lymphocyte and similar outcomes.MP should be tested in all IM children.The early diagnosis and treatment are the keys to improve the prognosis of IM children with EBV and MP infection. Key words: Infectious Mononucleosis; Epstein-Barr virus; Mycoplasma pneumoniae; Clinical characteristics; Children