| Objective Retrospective clinical analysis of infectious mononucleosis(IM)in children was conducted to summarize the characteristics of the disease and improve the understanding of the disease.Methods Data of 100 children with IM who lived in General Hospital of Ningxia Medical University from January 2015 to December 2018 were collected,and their general conditions,prodrome manifestations,clinical symptoms and signs,laboratory examinations,concomitant diseases and treatment outcomes were recorded and statistically analyzed.Results1.Analysis of the general situation of morbidity:The number of children with IM was the highest in spring,accounting for 32.0% of the total number,followed by summer,autumn and winter,accounting for 29.0%,24.0% and 15.0% respectively.Generally distributed,it is common in preschool children aged 3-7 years,accounting for 49.0% of the total number,followed by children,school-age children,accounting for 28.0%,21.0%respectively,infants are rare,accounting for 2.0%.The ratio of male to female was 1.27:1.There was no significant difference in gender among all age groups(infants,preschool age and school-age)(P > 0.05).2.The first presentation was diverse.Fever and eyelid edema were the most common,accounting for 77.0% and 45.0%,respectively,followed by cough(42.0%)and lymph node enlargement(35.0%).The prodrome has a variety of manifestations with varying degrees of severity,which may easily lead to misdiagnosis at the beginning of the disease,In thisstudy,70.5%(36/51)of children misdiagnosed as respiratory tract infection,17.6%(9/51)of the children with a diagnosis of fever in dispute,eyelid edema,or abnormal urinalysis performed pending investigation,5.9%(3/51)of the children was misdiagnosed as acute lymphadenitis,3.9%(2/51)of the children were misdiagnosed as glomerulonephritis,2.0%(1/51)of the children was misdiagnosed as conjunctivitis.There was no significant difference in prodrome and performance between different age groups(P > 0.05).The main clinical manifestations and signs were lymph node enlargement(95.0%),angina(94.0%),fever(88.0%),liver and/or spleen enlargement(55.0%)and skin rash(18.0%).The clinical manifestations and physical signs of different age groups showed that the incidence of rash in infants and young children was higher than that of school-age children aged 3-7 years(P <0.05).3.Laboratory index analysis:Blood routine changes were mainly caused by the total number of white blood cells,percentage of lymphocytes,and percentage of monocytes,which accounted for 86.0%,92.0%,and 55.0% of the total number,respectively.A small number of children(4.0%)would suffer from thrombocytopenia or decreased hemoglobin.Atypical lymphocytes were detected in 97.0% of children with IM,of which 77.3%(75 / 97)had atypical lymphocytes ? 6%,and 43.3%(42 / 97)had atypical lymphocytes ?10%.Biochemical routine tests showed that 67% of the children showed elevated AST and ALT.Urine routine examination was abnormal in 9.0% of the children,mainly manifested as urine protein +-~+and occulted blood +-~+.No obvious abnormalities were found in renal function during the same period.The virus test indicated that the pathogens of children with IM mainly had Epstein-Barr virus,followed by cytomegalovirus,herpes simplex virus,rubella virus and toxoplasma,and the positive samples were51.1%(46 / 90)?27.8%(25 / 90)?2.2%(2 / 90)and 1.1%(1 / 90),respectively.4.The difference between the misdiagnosis group and the timely and accurate diagnosisgroup was statistically significant(P < 0.05).5.Treatment and prognosis:All the 100 IM children were given ganciclovir antiviral treatment after admission and diagnosis,and the majority of them were treated for 7 to 15 days,accounting for 91.0%.Drug allergy,drug-related granulocytopenia and liver dysfunction occurred in 1.0%,1.0% and 2.0% of the children during treatment.The average hospital stay was 12 days.In this study,there were no severe cases or deaths,and all the children were discharged after improvement.Conclusion1.The incidence of infectious mononucleosis in children is high in spring,especially in preschool children.The onset forms of IM are various.The clinical manifestations of IM are atypical at the beginning of the disease,which can involve multiple systems of the whole body.The patients with eyelid edema are easy to be misdiagnosed.The clinical characteristics of IM are mainly fever,cervical lymph node enlargement,angina,and some of them have hepatosplenomegaly and(or)skin rash.2.The prognosis of the disease is generally good.Early recognition and reasonable treatment can improve the prognosis. |
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