Comprehensive insights into pediatric infectious mononucleosis: a retrospective study

Area of Science:

• Pediatric Infectious Diseases
• Virology
• Clinical Diagnostics

Background:

• Infectious mononucleosis (IM), primarily caused by Epstein-Barr virus (EBV), is common in children.
• Identifying predictors of IM severity, liver damage, and hospitalization duration is crucial for effective management.
• Enhancing diagnostic precision for EBV infections in pediatric populations is an ongoing challenge.

Purpose of the Study:

• To identify clinical and laboratory markers associated with infectious mononucleosis (IM) in children.
• To investigate risk factors contributing to liver damage and prolonged hospitalization in pediatric IM cases.
• To improve the accuracy of Epstein-Barr virus (EBV) diagnostics in children.

Main Methods:

• Retrospective analysis of 288 pediatric IM cases hospitalized between January 2023 and December 2024.
• Evaluation of clinical features, laboratory parameters, and EBV-DNA loads using statistical analyses.
• Identification of predictors for disease severity and patient outcomes.

Main Results:

• Fever, cervical lymphadenopathy, creatine kinase (CK), IgM, and CD4/CD8 ratios correlated with high EBV-DNA load.
• Liver damage (35.1%) was associated with age, splenomegaly, ALT, AST, GGT, LDH, ferritin, and immune markers (p < 0.05).
• Prolonged hospitalization linked to hepatomegaly, ALT, AST, GGT, LDH, and ferritin (p < 0.05). Fever predicted high EBV-DNA load; age, LDH, and ferritin independently predicted liver damage; hepatomegaly predicted extended hospitalization.

Conclusions:

• Infectious mononucleosis predominantly affects children aged 3-7 years.
• Fever is a predictor of high EBV-DNA load in pediatric IM.
• Elevated LDH, ferritin, and hepatomegaly are indicators for increased risk of liver damage and prolonged hospitalization, guiding management strategies.