’Predictors of hospitalization in children with infectious mononucleosis

Abstract

Background: Infectious mononucleosis (IM), characterized by fever, lymphadenopathy and pharyngitis, is a common infectious disease caused by Epstein-Barr virus (EBV). In this study, we performed a retrospective analysis of the clinical findings, laboratory data and management of children with IM due to EBV to find out the predictors of hospitalizations. Methods:We retrospectively reviewed the medical records of patients under the age of 18 years who were diagnosed with IM between October 31, 2017 and October 31, 2018 at Muğla Sıtkı Koçman University Medical Faculty Hospital. The study population was categorized into three groups according to the age; the 0-4 years, 5-10 years, and above 10 years. Complaints, physical examination findings, laboratory data, complications and treatment strategies of the patients were compared in these groups. Factors associated with hospitalizations and predictors of hospitalization were also investigated.Results: This study included 158 patients. The mean age of the patients was 88.9 ± 53.5 months and 93 (58.9%) were male. The most common complaint was fever (57.6%), and the most common physical examination finding was hepatomegaly (73.4%). No significant difference was found between the age groups in most of the clinical and laboratory findings. The antibiotic treatment was administered in 44% of the patients and 34.8% of the patients were required hospitalization. Patients who needed hospitalization were more symptomatic, had more physical examination findings and had higher acute phase reactants. For variables were found to be significant predictors of hospitalization: presence of fever, palatal petechiae, or exudative tonsillitis and higher levels of C-reactive protein at presentation.Conclusions: More than one third of the children with IM required hospitalization. Presence of fever, palatal petechiae, or exudative tonsillitis and higher levels of C-reactive protein at presentation were ssociated with higher rates of hospitalizations. Key words: Infectious mononucleosis, children, clinical features