Correlates of illness severity in infectious mononucleosis

被引:26
作者
Odame, John [1 ]
Robinson, Joan [2 ]
Khodai-Booran, Nasser [1 ]
Yeung, Simon [1 ]
Mazzulli, Tony [3 ]
Stephens, Derek [4 ]
Allen, Upton D. [1 ,4 ]
机构
[1] Hosp Sick Children, Div Infect Dis, Toronto, ON M5G 1X8, Canada
[2] Univ Alberta, Stollery Childrens Hosp, Div Infect Dis, Edmonton, AB, Canada
[3] Univ Toronto, Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada
[4] Hosp Sick Children, Res Inst, Toronto, ON M5G 1X8, Canada
基金
加拿大健康研究院;
关键词
Epstein-Barr virus; Hepatitis; Mononucleosis; Viral load; EPSTEIN-BARR-VIRUS; HEPATITIS;
D O I
10.1155/2014/514164
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV) complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses. OBJECTIVES: To determine the clinical and laboratory correlates of illness severity among infants, children and youth with infectious mononucleosis (IM). METHODS: Study subjects with confirmed IM were prospectively enrolled. Illness severity was assessed at baseline and at six weeks using a scoring tool. Peripheral blood viral loads served as a measure of viral burden. RESULTS: Among 32 children and young adults with IM, the median age was 16 years (range two to 24 years). The predominant clinical findings were lymphadenopathy (23 of 32 [72%]), pharyngitis (16 of 32 [50%]), fever (nine of 32 [28%]) and splenomegaly (six of 32 [19%]). With respect to symptoms or signs that persisted to at least six weeks after illness onset, the predominant complaint was lymphadenopathy in 35% of subjects available for reassessment. Deranged liver function tests were present at presentation in up to 44% of subjects. Patients with the highest viral loads at presentation had significantly higher illness severity scores associated with fatigue (P=0.02). Other than the scores associated with fatigue, viral load values were not significantly correlated with the illness severity scores at baseline and at six weeks. CONCLUSION: In IM, viral loads are not necessarily correlated with illness severity, with the exception of fatigue. EBV-related hepatitis is common in IM, confirming the status of this virus as a relatively common cause of transient hepatitis in children and youth. This entity is not necessarily a marker of disease severity.
引用
收藏
页码:277 / 280
页数:4
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