L.V. PUZYREVA¹, T.E. SHVETS¹, N.V. GOLOVANOVA², N.A. SABAEVA^1, 2, E.A. FADYUSHINA², E.P. SHEFER², A.V. KOMAROVA¹, I.M. FLORIAN²

 ¹Omsk State Medical University, Omsk

²City Children’s Clinical Hospital No. 3, Omsk

Contact details:

Puzyreva L.V. — MD, Associate Professor, Head of the Department of Pediatric Infectious Diseases

Address: 12 Lenin St., 644099 Omsk, Russian Federation, tel.: +7-913-149-1232, e-mail: puzirevalv@mail.ru

Infectious mononucleosis is an infectious disease most commonly caused by viruses of the Herpesviridae family. Despite the pronounced clinical symptoms, the diagnosis is rarely established in the first days of the disease, and patients apply to doctors of various specialties.

The purpose — to describe the clinical manifestations and results of diagnostic examination of patients with infectious mononucleosis who were on inpatient treatment in a hospital for children’s infectious diseases.

Material and methods. Basic medical documentation was used. The age of the patients was from 3 to 17 years 29 days. Standard methods of statistics were used.

Results. Most of the children treated were of preschool and school age. Most often, the clinical picture developed acutely with bright symptoms. 86.8% of children sought medical help from a pediatrician and an otorhinolaryngologist during the first two days. Almost half of the children received antibacterial treatment, but with no apparent improvement. Infectious mononucleosis was timely diagnosed in only 32.7% of patients. Exanthema was observed in 1/4 of patients and in severe cases persisted for up to 10 days. The rash varied from maculopapular to hemorrhagic. Atypical mononuclear cells in peripheral blood appeared in the second week of the disease. Microbiological diagnostics in the oropharynx determined the growth of the commensal Str.viridans (69.5%) or opportunistic microflora (62.1%), which most likely led to the development of lacunar bacterial tonsillitis. The Epstein — Barr virus was the most frequent cause of infectious mononucleosis, while in children from 1 to 3 years old it was cytomegalovirus. There was also a combined contamination with types 4 and 5 herpes viruses.

Conclusion. Thus, a low proportion of timely diagnosis of infectious mononucleosis remains even under the typical clinical picture. Creating clear algorithms for the management of patients with suspected infectious mononucleosis will help to prevent complications and reduce the duration of hospital treatment.

Key words: infectious mononucleosis, Epstein — Barr virus, cytomegalovirus, clinical picture, timeliness of diagnosis, complications.

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