CLINICAL SPECTRUM OF INFECTIOUS MONONUCLEOSIS IN CHILDREN

Infectious Mononucleosis, the syndrome characterized by a classic triad of fever, sore throat and lymphadenopathy is most commonly caused by Epstein-Barr virus. Primary infection is usually asymptomatic or produce an acute illness that is often not recognized as being due to EBV. We sought to explore the clinical spectrum of Infectious Mononucleosis in Albanian children, so we conducted a retrospective study of a 5 year period (2010- 2014), where were included all children aged 0-14 years hospitalized in the Pediatric Infectious Disease Ward of the University Medical Center “Mother Teresa” diagnosed as having AIM based on a positive serology for immunoglobulin M viral capsid antigen. Clinical, demographic parameters and laboratory results were extracted from hospitalization records. In the typical form of IM are classified all the cases presented with fever, pharyngitis and lymphadenopathy; in the atypical form are classified all other cases. Of the 107 children with AIM 67 (63%) presented the typical clinical form of IM, 40 (37%) presented the atypical clinical form. In the age group 0-2y 44% were in atypical form and 56% in typical form; in the age group 2-6y 43% were in atypical form and 57% in typical form; in the age group 6-14y 26% were in atypical form and 74% in typical form. Mean age of the atypical form is 4.9years and mean age of the typical form is 5.7years. Mean value of white blood cells in typical form is 16,843cells/ml, in atypical form is 15,730cells/ml. Mean duration of fever in atypical form is 8.25days, in typical form is 7.6days. Mean of hospitalization in typical form is 7.5days, in atypical form is 7.1days. The risk of developing Infectious Mononucleosis after primary EBV infection correlates with age of the patient, younger children are usually asymptomatic or moderately ill with a partial Infectious Mononucleosis syndrome, although classic IM can occur in this age group.