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Epstein-Barr virus infectious mononucleosis in children. I. Clinical and general laboratory findings

C V Sumaya, Y Ench

    Pediatrics
    |June 1, 1985
    PubMed

    Insights

    Epstein-Barr virus (EBV) causes infectious mononucleosis in children, with younger children experiencing unique symptoms like rashes and neutropenia. This study highlights age-related differences in EBV mononucleosis presentation and complications in pediatric patients.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Virology

    Background:

    • Epstein-Barr virus (EBV) is a common human herpesvirus.
    • Infectious mononucleosis (IM) is a common manifestation of primary EBV infection.
    • Clinical presentation of IM in children, especially young children, is less well-defined than in adults.

    Purpose of the Study:

    • To prospectively investigate the clinical presentation and complications of Epstein-Barr virus-induced infectious mononucleosis in children.
    • To identify age-related differences in the manifestation of infectious mononucleosis in pediatric populations.
    • To compare the clinical features of childhood EBV mononucleosis with those reported in adult patients.

    Main Methods:

    • Prospective and serial study of 113 children aged 6 months to 16 years with documented EBV-induced infectious mononucleosis between 1976 and 1982.
    • Clinical data collection included symptoms, physical examination findings, and laboratory results.
    • Analysis focused on identifying age-specific patterns and complications.

    Main Results:

    • An unexpected high incidence of EBV mononucleosis was observed in children under 4 years old.
    • Younger children presented with more frequent rashes, neutropenia, and abdominal pain compared to older children and adults.
    • Age-related differences were noted in atypical lymphocytosis, with lower intensity in younger children.
    • Unique or more frequent childhood manifestations included failure to thrive, otitis media, and recurrent tonsillopharyngitis.
    • Complications like thrombocytopenia, airway obstruction, and neurologic issues were more frequent, while jaundice was less common than in adults.
    • Pneumonia occurred in six children, all under 4 years old.

    Conclusions:

    • Infectious mononucleosis due to Epstein-Barr virus exhibits distinct clinical features in young children compared to older children and adults.
    • Age is a significant factor influencing the presentation and complications of EBV mononucleosis in pediatric patients.
    • Further research, aided by improved EBV-specific testing, is crucial for a comprehensive understanding of this disease across all pediatric age groups.

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