LYMPHADENOPATHY AS AN ESSENTIAL SIGN OF INFECTIOUS MONONUCLEOSIS

Infectious Mononucleosis is the best known clinical syndrome caused by Epstein-Barr virus. EBV infection is characterized by a vigorous humoral and cellular immune response to rapidly proliferating EBV- infected B cells, which results in lymphadenopathy and other signs and symptoms of Infectious Mononucleosis. As lymphadenopathy characterizes IM we studied its anatomic location and age distribution in children. 107 children aged 0-14 years were included in the study. All cases were hospitalized in the Pediatric Infectious Diseases Ward of the University Medical Center “Mother Teresa” during 2010-2014, diagnosed upon a positive serology for immunoglobulin M viral capsid antigen. Clinical and laboratory results were extracted from medical records. 62(57%) cases presented cervical lymphadenopathy, 26(24%) cases presented generalized lymphadenopathy. Cervical lymphadenopathy: 9% of cases are in the age-group 0-2y, 64% in the age-group 2-6y and 27% in the age-group 6-14y. Generalized lymphadenopathy: 19% of cases are in the age-group 0-2y, 16% in the age-group 2-6y and 65% in the age-group 6-14y. Median age of cervical lymphadenopathy is 5.1years, median age of generalized lymphadenopathy is 7.1years. In generalized lymphadenopathy 62% of cases presented hepatomegaly and 54% presented splenomegaly; in cervical lymphadenopathy 12% of cases presented hepatomegaly and 32% presented splenomegaly. In generalized lymphadenopathy 81% of cases had lymphocytes level >60%; in cervical lymphadenopathy 51% of cases had lymphocytes level >60%. Lymphadenopathy is an essential sign of Infectious Mononucleosis. Generalized lymphadenopathy is more characteristic in the advancing age and is a sign of severity of the disease.