Acute EBV mononucleosis in children of various ages hospitalized in the infectious hospital of the St. Petersburg State Pediatric Medical University in 2017–2020

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Abstract

BACKGROUND: The problem of acute EBV-mononucleosis is one of the most urgent in pediatrics. In the structure of the incidence of infectious mononucleosis, the proportion of the child population is 70–80%, children 4–8 years old are more often ill. Maternal antibodies protect an infant only in the first months of life, primary infection may occur at 3 months of age, and a manifest form of acute EBV-mononucleosis may develop at 6 months of age.

AIM: The aim of the study was to analyze peculiarities of acute EBV-mononucleosis in children of different ages hospitalized in the infectious diseases hospital of the Saint Petersburg State Pediatric Medical University.

MATERIALS AND METHODS: The article presents data on 376 children aged 1 to 18 years with a diagnosis of Acute EBV mononucleosis, hospitalized in the period 2017–2020. In the infectious diseases department No. 1 of Saint Petersburg State Medical University. Etiological interpretation was carried out using ELISA (determination of IgM to VCA in the blood) and detection of EBV DNA in the blood by PCR.

RESULTS: In 89.6% of cases, the disease was of moderate severity. Acute onset of the disease was noted in 69.7% of cases, more often in children from 1 to 10 years old. Intoxication syndrome was observed with the same frequency in all age groups. Febrile fever was observed in 96.0% of patients. The syndrome of acute tonsillitis, lymphadenitis was detected in all patients. The phenomena of adenoiditis and hepatomegaly were more pronounced in younger children. Splenomegaly was recorded in 74.5% of cases, more often than hepatomegaly. Cytolysis syndrome was observed in every second child. In older age groups, there was a higher level of hyperenzymemia and a pronounced mononuclear reaction in the hemogram.

CONCLUSION: All the analyzed patients had a typical clinical picture of acute EBV mononucleosis with a characteristic syndrome complex. In most cases, the disease was of moderate severity, severe severity was recorded in 8.2% — mainly in older children. Involvement of the liver and spleen in the pathological process simultaneously took place in every second patient. In older age groups, there was a higher level of hyperfermentemia and a pronounced mononuclear reaction in the hemogram.

About the authors

Anna V. Fedorova

Saint Petersburg State Pediatric Medical University

Email: aanna.fedorova@gmail.com
ORCID iD: 0000-0003-2870-4344
SPIN-code: 1198-4914

Assistant Lecture, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Vera F. Sukhovetskaya

Saint Petersburg State Pediatric Medical University

Author for correspondence.
Email: verafedotovna@mail.ru
ORCID iD: 0000-0002-1566-7137
SPIN-code: 3633-2952

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Vladimir N. Timchenko

Saint Petersburg State Pediatric Medical University

Email: timchenko220853@yandex.ru
ORCID iD: 0000-0002-4068-1731
SPIN-code: 8594-0751

MD, PhD, Dr. Sci. (Med.), Professor, Head, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Andrey G. Vasilyev

Saint Petersburg State Pediatric Medical University

Email: avas7@mail.ru

MD, PhD, Dr. Sci. (Med.), Professor, Head, Department of Pathological Physiology with a Course of Immunopathology

Russian Federation, Saint Petersburg

Tatyana A. Kaplina

Saint Petersburg State Pediatric Medical University

Email: k.kta@yandex.ru
ORCID iD: 0000-0003-1659-2058
SPIN-code: 1381-9580

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Svetlana L. Bannova

Saint Petersburg State Pediatric Medical University

Email: deva0509@mail.ru
ORCID iD: 0000-0003-1351-1910
SPIN-code: 9654-9386

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Elena V. Barakina

Saint Petersburg State Pediatric Medical University

Email: elenabarakina@mail.ru
ORCID iD: 0000-0002-2128-6883
SPIN-code: 9313-2879

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Tatyana M. Chernova

Saint Petersburg State Pediatric Medical University

Email: t-chernova@mail.ru
ORCID iD: 0000-0003-4845-3757
SPIN-code: 3146-3629

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Maria D. Subbotina

Saint Petersburg State Pediatric Medical University

Email: m.03@bk.ru
ORCID iD: 0000-0001-8748-7146
SPIN-code: 1458-6062

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Natalia V. Pavlova

Saint Petersburg State Pediatric Medical University

Email: pnv2403@yandex.ru
ORCID iD: 0000-0002-0661-6477
SPIN-code: 4174-5062

MD, PhD, Cand. Sci. (Med.), Assistant Professor, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Anna N. Nazarova

Saint Petersburg State Pediatric Medical University

Email: anyta19@bk.ru
ORCID iD: 0000-0002-4678-4328
SPIN-code: 3375-2127

Assistant Lecturer, Professor M.G. Danilevich Department of Infectious Diseases in Children

Russian Federation, Saint Petersburg

Oksana V. Bulina

Saint Petersburg State Pediatric Medical University

Email: oksanabulina@yandex.ru
ORCID iD: 0000-0002-2997-7777
SPIN-code: 7960-2040

Cand. Sci. (Med.), Assistant Professor, Department of Rehabilitology Faculty of Retraining and Additional Professional Education

Russian Federation, Saint Petersburg

Elena B. Pavlova

Saint Petersburg State Pediatric Medical University

Email: infarm@bk.ru
ORCID iD: 0000-0002-7596-1004
SPIN-code: 8900-3143

Cand. Sci. (Med.), Assistant Professor, Department of Pharmacology with a course of clinical pharmacology, pharmacoeconomics

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Distribution of hospitalized children with acute EBV mononucleosis depending on age and sex (n = 376)

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3. Fig. 2. The proportion of hospitalized children with acute EBV mononucleosis in different seasons of the year (n = 367)

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4. Fig. 3. Severity of acute EBV mononucleosis in hospitalized patients of different ages (n = 367)

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5. Fig. 4. Clinical symptoms (%) of acute EBV mononucleosis in hospitalized children in different age groups (n = 376). 1 — intoxication; 2 — fever; 3 — acute adenoiditis; 4 — acute tonsillitis with plaque on the palatine tonsils; 5 — acute tonsillitis without plaque on the palatine tonsils; 6 — lymphadenopathy; 7 — hepatomegaly; 8 — splenomegaly

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