[THE FEATURES OF THE COURSE OF INFECTIOUS MONONUKLEOSIS OF DIFFERENT ETIOLOGY IN CHILDREN]

Area of Science:

• Pediatrics
• Infectious Diseases
• Virology

Background:

• Infectious mononucleosis (IM) is a common childhood illness.
• The etiology of IM can involve several herpes viruses, primarily Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus 6 (HHV-6).
• The clinical presentation of IM can vary, suggesting that the causative agent may play a role.

Purpose of the Study:

• To investigate the impact of different causative pathogens (EBV, CMV, HHV-6, and mixed infections) on the clinical and paraclinical manifestations of infectious mononucleosis in children.
• To correlate specific viral etiologies with distinct symptom profiles and disease severity in pediatric IM cases.

Main Methods:

• A clinical and laboratory study was conducted on 410 children aged 10 months to 12 years diagnosed with infectious mononucleosis.
• Data collected included clinical symptoms, fever patterns, tonsillitis presence, organomegaly (hepatomegaly, splenomegaly), and laboratory findings such as white blood cell counts (leukocytosis, lymphocytosis, monocytosis, neutrophilia), atypical mononuclear cells, and anemia.
• Statistical analysis was used to associate specific pathogens with observed clinical and laboratory parameters.

Main Results:

• Herpes viruses, predominantly EBV, CMV, and HHV-6, were implicated in the clinical picture of IM in 52.9% of cases.
• EBV mononucleosis typically presented with acute onset (79.5%), intoxication (70.5%), fever up to 7 days (61.03%), lacunar tonsillitis (85.8%), hepatomegaly (88.2%), splenomegaly (63.8%), moderate severity (81.7%), lymphocytosis (62.9%), and monocytosis (20.5%).
• CMV mononucleosis was characterized by acute onset (89.9%), severe course (29.8%), prolonged fever (>7 days) (56.7%), neutrophilic leukocytosis (73.55%), atypical mononuclear cells (64.7%), and anemia (29.7%). HHV-6 infection presented with severe symptoms (33.3%), prolonged high fever (50%), exanthema (33.3%), pharyngitis without tonsillitis (66.7%), leukocytosis (66.7%), elevated ESR (66.7%), and monocytosis (33.3%). Mixed infections (MIXT) showed acute onset (78.3%), intoxication (79.7%), lacunar tonsillitis (92.9%), hepatomegaly (84.1%), splenomegaly (67%), fever up to 7 days (62.15%), lymphocytosis (55.3%), neutropenia (57.4%), atypical mononuclear cells (48.2%), and hypochromic anemia (17.29%).

Conclusions:

• The specific etiology of infectious mononucleosis in children significantly influences the acuity, severity, and intensity of clinical and paraclinical manifestations.
• Distinct clinical and laboratory profiles are associated with EBV, CMV, HHV-6, and mixed viral infections, aiding in differential diagnosis.
• Understanding pathogen-specific presentations is crucial for effective management and prognosis of infectious mononucleosis in pediatric populations.