Korean J Otorhinolaryngol-Head Neck Surg.  2019 Nov;62(11):642-646. 10.3342/kjorl-hns.2019.00150.

Clinical Characteristics of Infectious Mononucleosis: A Retrospective Study

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea. kytae@hanyang.ac.kr

Abstract

BACKGROUND AND OBJECTIVES
Infectious mononucleosis is mainly caused by Epstein-Barr virus infection and it presents sore throat, fever, tonsillar enlargement with exudate, cervical lymphadenopathy, hepatosplenomegaly, and etc. Therefore, it is often misdiagnosed with acute tonsillitis. The aim of this study was to evaluate the clinical characteristics of patients with infectious mononucleosis and recent changes.
SUBJECTS AND METHOD
From January 2008 to December 2017, we retrospectively studied 83 patients who were diagnosed with infectious mononucleosis. We evaluated the patients' clinical characteristics such as sex, age, onset of disease, the department first visited, period of hospital stay, symptoms, signs, the results of serologic test, and complications.
RESULTS
Among 83 patients, 41 were male and 42 were female. The mean age was 16.1±7.28, with the oldest patient being 38 years old and the youngest patient being 2 years old. The proportion of patients older than 25 years was 10.8%. The most common symptom was sore throat (77%), followed by fever (67%), upper respiratory infection symptoms such as cough, sputum, rhinorrhea (37%), abdominal pain (16%), neck mass or neck pain (13%), and headache (4%). The most common sign was tonsillar enlargement (85%), followed by tonsillar white patch (68%), hepatosplenomegaly (67%), and cervical lymphadenopathy (60%). Complication occurred in 2 patients with mild jaundice, and there was no critical complication. The department patients first visited was mostly otolaryngology (61%), followed by pediatrics (21%), gastroenterology (9%), and others (6%).
CONCLUSION
Patients with infectious mononucleosis mostly appeared to have fever, pharyngitis or cervical lymphadenitis, and the complication rate was low. The primary infection age of infectious mononucleosis tended to increase in recent years. In adult patients, cervical lymphadenitis was less, and white blood cell count and the proportion of lymphocyte was lower compared to pediatric patients.

Keyword

Cervical lymphadenitis; Epstein-Barr virus; Infectious mononucleosis

MeSH Terms

Abdominal Pain
Adult
Cough
Exudates and Transudates
Female
Fever
Gastroenterology
Headache
Herpesvirus 4, Human
Humans
Infectious Mononucleosis*
Jaundice
Length of Stay
Leukocyte Count
Lymphadenitis
Lymphatic Diseases
Lymphocytes
Male
Methods
Neck
Neck Pain
Otolaryngology
Palatine Tonsil
Pediatrics
Pharyngitis
Retrospective Studies*
Serologic Tests
Sputum
Tonsillitis
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