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936 Prevalence and Manifestations of Infectious Mononucleosis-Like Syndrome in a Children’s Hospital in Greece
  1. C Koutsaftiki1,
  2. I Mammas2,
  3. SA Kassina2,
  4. A Kapetanaki2,
  5. E Kotsari2,
  6. A Makri3,
  7. A Voyatzi3,
  8. M Kousouri2
  1. 1Pediatrics, Penteli’s General Children’s Hospital
  2. 21st Pediatric Department, Penteli’s Children’s Hospital
  3. 3Department of Clinical Microbiology and Immunology, Penteli’s Children’s Hospital, Athens, Greece

Abstract

Introduction Infectious Mononucleosis Syndrome (IMS), is characterized by fever, lymphadenopathy, tonsillitis, hepatomegaly, spleenomegaly. Also peripheral lymphocytosis with >10% atypical lymphocytes is present. It is attributed mostly to Epstein-Barr virus (EBV), less to Cytomegalovirus (CMV) and rarely to Herpes Simplex Virus (HSV) and others.

Occasionally, atypical manifestations and serious complications might occur.

Objective Estimating the prevalence of the disease, the responsible infectious agents and of the typical and atypical manifestations in pediatric populations.

Material and Methods Within 12months, 700 serum samples were examined, from children 1–15 years old. Specimens’ laboratory investigation included: 1) indirect immunofluorescence, detecting IgG-IgM antibodies against EBV’s Viral Capsid Antigen (VCA), 2) Immuno Chemistry luminescence determination of CMV’s IgG-IgM antibodies, 3) EIA, identifying HSV’s IgG-IgM antibodies.

Results Typical clinical findings were: prolonged fever (89%), lymphadenopathy (82%), tonsillitis (57%), hepato-spleenomegaly (40%), cough (20%) and skin eruption (10%). Atypical manifestations were: menimgoencephalitis in 2 children, 22months and 7 years old (caused by EBV and HSV1 respectively), haemophagocytic lymphoistiocytosis in an 8 year old (by EBV), Gianotti-Crosti syndrome in an 18 months old (by EBV) and pneumonia in a 22months old (by EBV). In meningoencephalitis, viral DNA was detected using PCR in cerebrospinal fluid while in the remaining cases, positive IgM antibodies were found. Of the 700 children examined, 56 (8%) had positive serology for EBV, 29 (4.14%) for CMV and 1 for HSV 1.

Conclusions IMS is often amongst Greek children. 65% of the cases are attributed to EBV and 35% to CMV which is in accordance to the international literature.

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