Clinical features and laboratory findings in children hospitalized with acute Epstein-Barr virus infection: a crosssectional study in a tertiary care hospital

Çağlar, İlknur; Topal, Sevgi; Çokboz, Melike Kurtuluş; Düzgöl, Mine; Kara, Ahu; Bayram, Nuri; Apa, Hurşit; Devrim, İlker

doi:10.24953/turkjped.2019.03.008

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…The incidence of overall rash among IM children treated with antibiotics in this study was 13.04%, which was lower than that recorded in most studies ( 4 – 6 , 8 , 9 , 12 ) but close to that reported by Davis (14.89%) ( 7 ), Hocqueloux et al (15.32%) ( 10 ), and Misirlioglu et al (16.67%) ( 11 ). Furthermore, only 46.70% of rashes in this study overall were probably associated with antibiotic exposure, so the actual incidence (7.79%) of antibiotic-induced rash was much lower.…”

Section: Discussionsupporting

confidence: 60%

“…Since fever, pharyngitis, fatigue, and lymphadenopathy are common presenting symptoms in the outpatient setting, IM is often mistaken for other entities, such as acute bacterial tonsillitis ( 3 ). However, despite the fact that IM is a benign self-limiting disease that does not require antimicrobial therapy, previous studies have demonstrated that 54.30% to 84.00% of IM patients continue taking antibiotics empirically throughout the course of their disease ( 4 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

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Association between Antibiotic Exposure and the Risk of Rash in Children with Infectious Mononucleosis: a Multicenter, Retrospective Cohort Study

Zhang

Mao²,

et al. 2023

Antimicrob Agents Chemother

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Association between Antibiotic Exposure and the Risk of Rash in Children with Infectious Mononucleosis: a Multicenter, Retrospective Cohort Study

Zhang

Mao²,

et al. 2023

Antimicrob Agents Chemother

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“…11 Regarding laboratory parameters, the most frequent abnormality was elevated liver enzymes (54%), as previously described in other studies. 12 Interestingly, the increase in transaminases was particularly frequent in febrile patients (69%) and in the EBV-CMV group (62%).…”

Section: Discussionmentioning

confidence: 95%

Acute Epstein–Barr virus infection: Diagnostic challenge in young children, risk factors for hospitalisation and cytomegalovirus co‐detection

et al. 2023

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Aim: Acute Epstein-Barr virus (aEBV) and cytomegalovirus (CMV) infections frequently have similar manifestations. We aim to evaluate the characteristics of aEBV infection, risk factors for hospitalisation and differences according to CMV IgM detection (EBV-CMV co-detection) in children. Methods:Retrospective, single-centre study including patients <16 years diagnosed with aEBV infection (positive anti-EBV IgM/Paul-Bunnell test and acute symptomatology). EBV-CMV co-detection was defined as positive CMV IgM. Factors associated with age, hospitalisation and EBV-CMV co-detection were analysed in a multivariate analysis.Results: A total of 149 patients were included (median age 4.6 years). Most frequent manifestations were fever (77%), cervical lymphadenopathy (64%) and elevated liver enzymes (54%). Younger children had lower rate of positive Paul-Bunnell test (35% vs. 87%; p < 0.01), but higher rate of EBV-CMV co-detection (54% vs. 29%; p = 0.03). These children tended to have less typical symptoms of infectious mononucleosis and higher hospitalisation rate. The overall antibiotic prescription was 49%. Hospitalisation (27 children; 18%) was independently associated with prior antibiotic therapy and anaemia. Sixty-two cases (42%) had EBV-CMV co-detection, which was independently associated with elevated liver enzymes and younger age. Conclusion:In this study, younger children with aEBV infection presented more frequently with atypical clinical symptoms, had higher EBV-CMV co-detection rates and were more often hospitalised. Hospitalisation was associated with prior antibiotic prescription.

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“…IM can often present atypically [41], particularly in younger patients (<5 years age group) with many cases going undiagnosed - particularly if the diagnosis relies solely on the detection of nonspecific heterophile antibodies (HAs) to confirm clinically suspect cases [42,43]. Detection of HAs, most often performed using the Monospot test, is a specific yet insensitive test for diagnosing IM, particularly in the <5-year age group [44,45,46 ▪ ,47]. Patients who present with atypical lymphocytes (mononucleosis) on microscopy and have a low HA titre result should always have follow up specific EBV serology performed when the suspicion of IM is high [23].…”

Section: Epidemiologymentioning

confidence: 99%

Infectious mononucleosis: new concepts in clinical presentation, epidemiology, and host response

Naughton,

Enright,

Lucey

2024

Current Opinion in Infectious Diseases

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Purpose of the review Infectious mononucleosis (IM) is an infectious disease that presents clinically in only a small percentage of individuals despite almost universal infection with the causative agent. Here, we review the latest concepts in the clinical presentation, epidemiology, and host response of this disease. Recent findings Several recently published papers/reviews describe IM as a condition caused by one of several etiologic agents including, cytomegalovirus (HHV-5), Roseola virus (HHV-6) and Toxoplasmosis amongst others; this review focuses on IM as solely caused by the human herpes virus 4 (HHV-4). Since the initial discovery of the virus in the 1960s and its subsequent discovery as the primary etiologic agent for IM it has been associated with several human cancers and autoimmune disorders. Recent published findings show a correlation between HHV-4 and the autoimmune disorder, multiple sclerosis (MS), suggesting earlier IM could possibly act as a causative factor. Considering the important links being made with IM to so many cancers and autoimmune disorders it is surprising that a standard investigative procedure has yet to be determined for this disease. A standard approach to the investigation of IM would ensure more cases are diagnosed, particularly atypical cases, this would benefit epidemiological studies, and more immediately help practitioners distinguish viral from bacterial throat infections, enabling them to treat accordingly. Summary The understanding of the latest concepts in clinical presentation, epidemiology and host response to IM would benefit greatly from the introduction of a standard procedure for its investigation and diagnosis.

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Clinical features and laboratory findings in children hospitalized with acute Epstein-Barr virus infection: a crosssectional study in a tertiary care hospital

Abstract: Devrim İ. Clinical features and laboratory findings in children hospitalized with acute Epstein-Barr virus infection: a cross-sectional study in a tertiary care hospital.

Cited by 9 publications

References 18 publications

Association between Antibiotic Exposure and the Risk of Rash in Children with Infectious Mononucleosis: a Multicenter, Retrospective Cohort Study

Association between Antibiotic Exposure and the Risk of Rash in Children with Infectious Mononucleosis: a Multicenter, Retrospective Cohort Study

Acute Epstein–Barr virus infection: Diagnostic challenge in young children, risk factors for hospitalisation and cytomegalovirus co‐detection

Infectious mononucleosis: new concepts in clinical presentation, epidemiology, and host response

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