2011, Number 98
Clinical and paraclinical features of infectious mononucleosis by Epstein-Barr virus in 162 patients at the National Institute of Pediatrics, 1970-2011
González SN, Monroy CVA, Piña RG
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Language: Spanish
References: 18
Page: 50-56
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ABSTRACT
Background: Infectious mononucleosis is a clinical syndrome mainly secondary to acute infection with Epstein-Barr virus in up to 90% of cases. Clinical manifestations include the characteristic triad of fever, lymphadenopathy and pharyngitis occurring in 90% of patients in developed countries.Objective: To describe the clinical, paraclinical and complications of infection with Epstein-Barr virus in children with infectious mononucleosis.
Material and method: A case study, retrospective, observational, transversal and descriptive. We systematically reviewed the medical records of patients younger than 18 years with clinical and serological diagnosis of infectious mononucleosis by Epstein-Barr attended in a third level hospital in Mexico City from November 1970 to April 2011. Were recorded: age, clinical features, laboratory results, complications and resolution of each one of them.
Results: There were 162 cases of infectious mononucleosis. The average age of diagnosis was 5.2 years. The most frequent sign was lymphadenopathy in 145 patients (89.5%), fever in 129 (79.6%), malaise in 113 (69.7%), pharyngitis in 90 (55.5%), hepatomegaly in 76 (46.9%), splenomegaly in 59 (36.4%), rash in 27 (16.6%), jaundice in 16 (9.8%), arthritis in 3 (1.85%), eyelid edema in 1 (0.61%) and conjunctivitis in 1 patient (0.61%). Lymphocytosis was found in 67 patients (41.3%), atypical lymphocytes in 39 (24%), elevated transaminases in 39 (31.2%) and hyperbilirubinemia in 16 patients (43.2%). The most frequent complications of infectious mononucleosis are hematologic and major were bicitopenia in 12 patients (7.4%), hemophagocytic syndrome in 10 (6.17%), thrombotic thrombocytopenic purpura in 8 (4.9%) and aplastic anemia in 8 patients (4.9 %). There were no deaths.
Conclusion: Infectious mononucleosis in developing countries occur at younger ages compared with industrialized countries, where those affected are adolescents. The characteristic triad of fever, lymphadenopathy and pharyngitis was expressed less frequently than in industrialized countries. Complications were also different, predominantly hematologic.
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