Clinical features of infectious mononucleosis in children

Abstract

Objective To investigate the clinical features of infectious mononucleosis (IM) in children, especially the key points of differential diagnosis between it and acute purulent tonsillitis, in order to avoid misdiagnosis and wrong treatment. Methods Forty-nine IM children and 228 suppurative tonsillitis children treated in the 924 Joint Service Support Force of the Chinese People’s Liberation Army Hospital from January 2015 to December 2017 were allocated into IM group and suppurative tonsillitis group, respectively. A retrospective analysis was performed on the clinical data from the two groups. Results IM accounted for 0.91%(49/5 400) of hospitalized children in the same period, and the proportion of patients with suppurative tonsillitis was 4.22%(228/5 400). However, the difference in fever days was significant between the two groups (P 0.05); on the contrary, there were significant differences in lymphocyte ratio, lymphocyte count, alanine aminotransferase and aspertate aminotransferase levels between the two groups (P<0.05). The level of C-reactive protein in the suppurative tonsillitis group was higher than that in the IM group (P<0.05). Conclusions Fever, cervical lymph node enlargement and tonsillitis are the typical clinical manifestations of IM. For tonsillitis children with fever and white pus, lymphocyte ratio and lymphocyte count, especially, the C-reactive protein and detection results of liver function should be paid more attention so as to avoid misdiagnosis and wrong treatments. Key words: Infectious mononucleosis; Suppurative tonsillitis; Clinical analysis; Differential diagnosis