Impact of infectious mononucleosis in a second level hospital

Abstract

Objective: To know the impact of the disease in a second level care hospital, which are the signs and symptoms shown by infected patients, which are the treatments usually administrated and which services are admitted. Material and methods: Retrospective descriptive analytical study among the population attending the Emergency service of Rafael Méndez Hospital of Lorca between January 1st 2011 and December 31st 2019 with an infectious mononucleosis diagnosis. Once the sample was obtained, the necessary clinical and analytical variables were collected from the clinical records. Results: 600 patients attended to the emergency service with a clinical diagnosis of infectious mononucleosis, which supposes an incidence of 0.4 cases each 1000 habitants per year. 42 patients with a middle age from 16.8 ± 9.26 years old were included, being 57.1% women. The serology for Epstein-Bar was positive on 29 patients, positive for cytomegalovirus on 1 patient and negative for both on 12 patients. The most frequent symptoms presented were fever (66.7%), odynophagia (73.3%) and dysphagia (62.7%). The alteration of the hepatic enzymes was observed on an 81.6%. Admission were made by internal medicine (44.4%), otorhinolaryngology (33.3%) and paediatrics (16.7%). The 55.5% (25) of patients was following a treatment with antibiotics at the moment of the admission. Conclusion: Mononucleosis usually presents mild symptoms and low rates of hospital admission. Asthenia has showed, in a significant way, a symptom linked to EBV mononucleosis. Neutropenia, thrombocytopenia, and elevated transaminases are the most distinctive laboratory features in EBV infectious mononucleosis. Training of primary care physicians would be useful in order to avoid the use of unnecessary antibiotics