Differential Diagnostic Aspects of Epstein-Barr Virus Infectious Mononucleosis in Children from the Standpoint of the Duration of the Infection
There is increased incidence of Epstein-Barr virus infection currently worldwide, including in Russia. Special attention of scientists attracts the problem of long-term persistence of the virus with the development of a chronic process. Purpose is to determine the possibility of differential diagnosis of primary Epstein-Barr virus infection and reactivation, occurring with clinical manifestations of infectious mononucleosis. Materials and methods. The study was included 152 children with clinical manifestations of infectious mononucleosis and activity Epstein-Barr virus infection. A comprehensive study was included dynamic clinical observation, analysis of the results of laboratory studies (General blood analysis, General urine analysis, biochemical blood analysis), calculation of the leukocyte index of intoxication, serological examination of the blood by ELISA. Results. Clinical picture of the reactivation of Epstein-Barr virus is characterized by an easier course, which was manifested in lesser severity and duration of main symptoms, such as tonsillitis, adenoiditis, lymphadenopathy, and hepatosplenomegaly. As the hematology «markers» of the reactivation identified a high ESR, neutrophilia, relative small number of atypical mononuclear cells (5%), high LII and normal biochemical parameters, reflecting the functional state of the liver. Correlation analysis of clinical symptom with haematological and serological indices showed appearance of a large number of clinical symptoms and the index of positivity of antibodies of different classes for reactivation Epstein-Barr virus. Conclusion. Clinical supervision for children with reactivation of Epstein-Barr virus should be longer, including the periodic fences General and biochemical blood tests, a dynamic study of ELISA and quantitative PCR of blood.