Correlates of illness severity in infectious mononucleosis.

March 3, 2017 at 7:24 am

Can J Infect Dis Med Microbiol. 2014 Sep;25(5):277-80.

Odame J1, Robinson J2, Khodai-Booran N1, Yeung S1, Mazzulli T3, Stephens D4, Allen UD5.

Author information

1Division of Infectious Diseases, Hospital for Sick Children, Toronto, Ontario;

2Division of Infectious Diseases, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta;

3Mount Sinai Hospital, University of Toronto;

4The Research Institute, Hospital for Sick Children, Toronto, Ontario.

5Division of Infectious Diseases, Hospital for Sick Children, Toronto, Ontario; ; The Research Institute, Hospital for Sick Children, Toronto, Ontario.

Abstractin English, French

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.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211352/pdf/idmm-25-277.pdf

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Entry filed under: Biología Molecular, Epidemiología, F.O.D, FIEBRE y RASH, Infecciones virales, Metodos diagnosticos, REPORTS, Update.

Infectious mononucleosis. Hepatitis colestásica por amoxicilina clavulánico de evolución tórpida


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