Evaluation of patients diagnosed with infectious mononucleosis

Abstract

Purpose: The aim of this study was to investigate the clinical findings and complications of patients diagnosed with Epstein-Barr virus (EBV)-induced infectious mononucleosis. Materials and methods: EBV VCA IgM seropositive patients, who were admitted to the Pediatric Hematology department between June 2010 and February 2013, were analyzed retrospectively. Patients were assessed by demographic characteristics, clinical symptoms and complications on admission. Results: Epstein-Barr virus (EBV) VCA IgM seropositivity was seen in 45 (%42.3) patients (26 girls,19 boys). Mean age was 96±34 months (8 months-16 years). Symptoms and clinical findings were as follows: fever (75.5%); cervical lymphadenopathies (48.8%), exudative tonsillitis (44.4%), splenomegaly (35.5%), eight of them had maculopapuler rash (17.7%), hepatomegaly (11.1%), anemia and trombocytopenia (8.8%), artralgia (4.4%). Mean hemoglobin levels were 10.2±2.3 g/dL, MCV was 11.4±3.6 10³/μL, mean platelet count was 238±87 10³/μL, mean CRP was 4.8±2.5 mg/L. Five patients were admitted with elevated transaminases (11.1%) had ALT levels at 296.5±45.2 U/L and AST levels at 346.5±46.4 U/L. All the patients’ peripheral blood smears were evaluated, 34% of the patients had downey cells. Four patients under went bone marrow aspiration. No atypical cells or blasts were seen. No complications were observed in any of the patients. Conclusion: Infectious mononucleosis can be seen with many different clinical findings such as organomegaly, maculopapular rash and bicytopenia. Clinical symptoms can be mixed with many other viral infections as well as malignancies. Thus peripheral blood smears should be assessed in order to exclude malignancies. Pam Med J 2014;7(3):210-213