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Clinical and laboratory differences between Epstein-Barr and cytomegalovirus infectious mononucleosis in children

Rasa Medović, Zoran Igrutinović, Ruzica Radojević-Marjanović

    Srpski Arhiv Za Celokupno Lekarstvo
    |June 10, 2016
    PubMed
    Abstract

    Insights

    Infectious mononucleosis in children presents differently depending on the cause, Epstein-Barr virus (EBV) or cytomegalovirus (CMV). CMV infection is linked to more abdominal pain, eyelid swelling, rash, fatigue, and thrombocytopenia, while EBV shows faster liver enzyme decline.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Virology

    Background:

    • Infectious mononucleosis is primarily caused by Epstein-Barr virus (EBV), with cytomegalovirus (CMV) being a less common agent.
    • Understanding the distinct clinical and laboratory features of EBV and CMV mononucleosis in children is crucial for accurate diagnosis and management.

    Purpose of the Study:

    • To delineate the clinical and laboratory distinctions between Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infectious mononucleosis in pediatric patients.
    • To identify specific symptoms, complications, and laboratory marker trends that differentiate EBV from CMV infections in children.

    Main Methods:

    • Retrospective cohort analytical study involving 137 children diagnosed with infectious mononucleosis over a six-year period.
    • Data collection included medical history, physical examination findings (inspection, palpation), laboratory tests, abdominal ultrasonography, and complication monitoring.
    • Statistical analysis was performed using SPSS 20 to compare clinical and laboratory parameters between EBV and CMV groups.

    Main Results:

    • Epstein-Barr virus (EBV) accounted for 85.4% of cases, while cytomegalovirus (CMV) comprised 14.6%. Children under eight and boys were more frequently affected.
    • Significant differences were observed in the frequency of stomachaches, eyelid swelling, skin rash, and fatigue between EBV and CMV groups.
    • While liver enzymes (transaminases) and lactic dehydrogenases decreased in both groups, transaminase levels declined significantly faster in EBV cases. Thrombocytopenia was more prevalent in CMV infections.

    Conclusions:

    • Cytomegalovirus (CMV) infectious mononucleosis in children is associated with a higher incidence of abdominal pain, eyelid swelling, skin rash, fatigue, and thrombocytopenia.
    • Epstein-Barr virus (EBV) infectious mononucleosis is characterized by a more rapid decline in transaminase levels during hospitalization.
    • These findings highlight key clinical and laboratory differences that aid in distinguishing between EBV and CMV etiologies of infectious mononucleosis in pediatric populations.

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