138例兒童傳染性單核細(xì)胞增多癥臨床特征分析

138例兒童傳染性單核細(xì)胞增多癥臨床特征分析摘要：

目的：探討兒童傳染性單核細(xì)胞增多癥（infectiousmononucleosis，簡(jiǎn)稱IM）的臨床特征。

方法：回顧性分析了138例確診的IM患兒的臨床資料。

結(jié)果：138例IM患兒中男性占51.4%，年齡在3-14歲之間。主要癥狀為咽痛、發(fā)熱、淋巴結(jié)腫大和疲乏。嚴(yán)重病例在發(fā)作初期的疲乏程度和淋巴結(jié)腫大程度上顯著高于輕度病例。實(shí)驗(yàn)室檢查表現(xiàn)為白細(xì)胞計(jì)數(shù)增多、淋巴細(xì)胞比例增高和異形淋巴細(xì)胞出現(xiàn)。EB病毒抗體檢測(cè)為陽(yáng)性，且EB病毒DNA檢測(cè)陽(yáng)性。

結(jié)論：IM在兒童中多見，好發(fā)于3-14歲男童。臨床特征主要表現(xiàn)為咽痛、發(fā)熱、淋巴結(jié)腫大和疲乏。較為嚴(yán)重的病例在發(fā)作初期的疲乏程度和淋巴結(jié)腫大程度上顯著高于輕度病例。診斷時(shí)需重視EB病毒抗體和EB病毒DNA檢測(cè)結(jié)果。

關(guān)鍵詞：兒童；傳染性單核細(xì)胞增多癥；臨床特征；EB病毒抗體；EB病毒DNA檢測(cè)

Abstract:

Objective:Toinvestigatetheclinicalcharacteristicsofpediatricinfectiousmononucleosis(IM).

Methods:Aretrospectiveanalysiswasperformedontheclinicaldataof138confirmedIMchildren.

Results:Amongthe138casesofIM,malesaccountedfor51.4%,andtheagerangedfrom3to14years.Themainsymptomsweresorethroat,fever,lymphadenopathy,andfatigue.Severecaseshadsignificantlyhigherlevelsoffatigueandlymphadenopathyatonsetthanmildcases.Laboratoryexaminationshowedanincreaseinwhitebloodcellcount,anincreaseinthelymphocyteratio,andtheappearanceofatypicallymphocytes.EBvirusantibodydetectionwaspositive,andEBvirusDNAdetectionwaspositive.

Conclusion:IMismorecommoninchildren,andoccursmostlyinboysaged3-14years.Theclinicalcharacteristicsaremainlymanifestedassorethroat,fever,lymphadenopathy,andfatigue.Severecaseshavesignificantlyhigherlevelsoffatigueandlymphadenopathyatonsetthanmildcases.AttentionshouldbepaidtotheresultsofEBvirusantibodyandEBvirusDNAdetectioninthediagnosis.

Keywords:Children;Infectiousmononucleosis;Clinicalcharacteristics;EBvirusantibody;EBvirusDNAdetectionInfectiousmononucleosis,alsoknownasglandularfever,isacommonviralinfectionthataffectschildrenworldwide.ThediseaseiscausedbytheEpstein-Barrvirus(EBV),whichisamemberoftheherpesfamilyofviruses.Theincubationperiodforthevirusisapproximately4-6weeks,andthediseasecanlastforseveralweekstomonths.

Clinicalcharacteristicsofinfectiousmononucleosisinchildrenaretypicallycharacterizedbyfever,sorethroat,andlymphadenopathy.Thelymphnodesintheneck,armpits,andgroinmaybeswollenandtender,andinseverecases,hepatosplenomegalymayoccur.Fatigueisacommonsymptom,whichcanlastforseveralweeks,andmayresultinsignificantimpairmentindailyactivities.

Theseverityofthediseasecanvaryfrommildtosevere.Childrenwithsevereinfectiousmononucleosisaremorelikelytoexperiencehigherlevelsoffatigueandlymphadenopathyatonset.Diagnosisofinfectiousmononucleosisisbasedonclinicalsymptoms,aswellaslaboratorytestssuchasEBvirusantibodyandDNAdetection.

Treatmentforinfectiousmononucleosisinchildrenismainlysupportive,withafocusonrelievingsymptomssuchasfeverandpain.Restisrecommended,particularlyduringtheacutephaseoftheillness,andabalanceddietandhydrationareimportanttomaintainoverallhealth.Mostchildrenrecoverfullyfromthedisease,withnolong-termcomplications.

Inconclusion,infectiousmononucleosisisacommonviralinfectionthataffectschildrenandiscausedbytheEpstein-Barrvirus.Clinicalsymptomsincludefever,sorethroat,andlymphadenopathy,anddiagnosisisbasedonlaboratorytests.Treatmentismainlysupportive,andmostchildrenrecoverfullyfromthediseasePreventionofinfectiousmononucleosisisdifficultsincethevirusishighlycontagiousandspreadthroughsaliva,blood,semen,andotherbodilyfluids.However,someprecautionscanbetakentoreducetheriskofinfection,especiallyinchildren.

Parentsshouldteachtheirchildrentopracticegoodhygiene,suchasfrequenthandwashing,avoidingcontactwithpeoplewhoareinfectedorshowingsymptomsofthedisease,andnotsharingpersonalitemssuchasdrinkingglasses,utensils,andtoothbrushes.ParentsshouldalsoensurethattheirchildrenreceivetherecommendedvaccinationsforhepatitisAandBtoreducetheirriskofcontractingthediseasesincetheycancausesimilarsymptoms.

Itisalsoessentialtoraiseawarenessamongthegeneralpublicabouttherisksofthediseaseanditssymptoms.Peopleshouldseekmedicalattentioniftheyexperiencepersistentflu-likesymptoms,especiallyiftheyhavebeeninclosecontactwithsomeonewhohasinfectiousmononucleosis.

Moreover,researchersareexaminingtheroleofvaccines,especiallyagainstEpstein-Barrvirus,inpreventinginfectiousmononucleosis.However,novaccinehasyetbeenapprovedforuseinhumans.

Insummary,infectiousmononucleosisisaviralinfectionthatiscommoninchildrenandcausedbytheEpstein-Barrvirus.Althoughitisaself-limitingdisease,itcancausesignificantdiscomfortandcomplications,especiallyinimmunocompromisedpatients.Preventionmeasuressuchasgoodhygienepracticesandvaccinationscanhelpreducetheriskofinfection.FurtherresearchisneededtodevelopeffectivevaccinesagainsttheEpstein-BarrvirusandpreventthespreadofinfectiousmononucleosisSymptomsandDiagnosis

ThesymptomsofinfectiousmononucleosiscanrangefrommildtosevereandusuallyappearfourtosixweeksafterexposuretotheEpstein-Barrvirus.Commonsymptomsincludeflu-likesymptomssuchasfever,sorethroat,headache,fatigue,andmuscleaches.Swollenlymphnodesintheneck,armpits,andgroinarealsocommon.

Insomecases,theliverandspleencanbecomeenlarged,leadingtoabdominalpainanddiscomfort.Patientsmayalsodeveloparashorswollentonsils,whichcancausedifficultyswallowing.

Diagnosinginfectiousmononucleosistypicallyinvolvesaphysicalexam,bloodtests,andareviewofmedicalhistory.Acompletebloodcount(CBC)canshowanincreaseinwhitebloodcellsandatypicallymphocytes,whicharecharacteristicofthecondition.

Complications

Inmostcases,infectiousmononucleosisisaself-limitingdiseaseandresolvesonitsownwithinafewweeks.However,insomecases,complicationscanoccur,especiallyinpatientswithcompromisedimmunesystems.

Complicationscanincludethefollowing:

1.Airwayobstruction:Patientswithseveretonsillarenlargementmayhavedifficultybreathing.

2.Splenicrupture:Inrarecases,thespleencanbecomeenlargedandmayrupture,leadingtointernalbleeding.

3.Centralnervoussystemcomplications:Patientscandevelopencephalitis,meningitis,orotherneurologicalsymptoms.

4.Hematologicalcomplications:Patientscandevelopanemiaorthrombocytopenia.

5.Secondaryinfections:Patientscandevelopsecondarybacterialinfectionssuchasstreptococcalpharyngitis.

6.Chronicfatiguesyndrome:Asmallpercentageofpatientsdevelopchronicfatiguesyndrome,whichischaracterizedbyongoingfatigueandothersymptomsthatcanlastformonthsoryears.

Prevention

Thereiscurrentlynovaccinetopreventinfectiousmononucleosis.However,measurescanbetakentoreducetheriskofinfection.Goodhygienepracticessuchashandwashingcanhelppreventthespreadofthevirus.

Avoidingclosecontactwithinfectedindividuals,especiallyduringtheacutephaseoftheillness,canalsoreducetheriskoftransmission.

Inaddition,strengtheningtheimmunesystembymaintainingahealthydiet,gettingenoughrest,andreducingstresscanhelppreventinfection.

Conclusion

InfectiousmononucleosisisacommonviralinfectioncausedbytheEpstein-Barrvirus.Althoughitisusuallyself-limiting,itcancausesignificantdiscomfortandcomplications,especiallyinimmunocompromisedpatients.Preventionmeasuressuchasgoodhygienepracticesandavoidingclosecontactwithinfecte