关键词: 疱疹病毒4型, 人, 传染性单核细胞增多症, 儿童, 临床表现

Abstract:

Objective To explore the clinical characteristics of children with Epstein-Barr virus (EBV) infection and infectious mononucleosis (IM). Methods A total of 72 children with EBV infection and IM infection admitted to Chengde Central Hospital from January 2021 to July 2022 were retrospectively analyzed. They were divided into EBV infection group ( n =37) and IM group ( n =35), and the clinical data of the two groups were compared.Resultss (1) General data: there were no significant differences in gender, age and peak temperature between the two groups ( P >0.05). Compared with that in IM group, the fever time in EBV infection group was significantly shorter ( P <0.05). (2) Initial symptom: fever was the initial symptom in both groups, and there was no significant difference in the incidence of initial symptom between the two groups ( P >0.05). (3) Clinical manifestations: there was no significant difference in the incidence of lymph node enlargement, rash and angina between the two groups ( P >0.05). Compared with that in the IM group, the EBV infection group had a significantly lower incidence of sore throat, eyelid edema, hepatomegaly, splenomegaly, and fever ( P <0.05). (4) Laboratory tests: a total of 20 patients in the two groups received laboratory testing of herpes simplex virus, cytomegalovirus, rubella virus, Mycoplasma pneumoniae, and adenovirus. Rubella virus was detected in all children who received serum virology test, and 17/20 (85%) children were detected with cytomegalovirus infection. There were no significant differences in the percentage of lymphocytes, and monocytes, as well as alanine aminotransferase and aspartate aminotransferase levels between the two groups ( P >0.05). Compared with those in the IM group, the white blood cell count in the EBV infection group was significantly higher, the percentage of abnormal lymphocyte and lactate dehydrogenase were significantly lower ( P <0.05). A total of 19 children in the IM group received immunological tests, and 14/19 (73.7%) had elevated serum immunoglobulin E levels. Nine patients in the EBV group received immunological tests, and 8/9 (88.9%) had elevated serum immunoglobulin E levels. There was no significant difference in the incidence of a higher-than-normal range of immunoglobulin E between the two groups ( P =0.630). (5) Complications: compared with IM group, the incidence of respiratory tract infection in EBV infection group was significantly lower ( P <0.05). There was no significant difference in the incidence of complications of other systems (blood system, liver, kidney, myocardium, digestive tract) ( P >0.05).Conclusion The clinical features of EBV infection differ from those of IM in children. Clinical manifestations like sore throat, eyelid edema, hepatomegaly, splenomegaly, fever, and laboratory tests of white blood cell count, lactate dehydrogenase, and percentage of lymphocytes should be well concerned in children.

Key words: herperirus rype 4, infectious mononucleosis, child, clinical manifestations