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Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults

Published online by Cambridge University Press:  23 September 2003

I. GROTTO
Affiliation:
Israel Defence Force Medical Corps, 19 Izmargad Street, Hod Hasharon 45045, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
D. MIMOUNI
Affiliation:
Department of Dermatology, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205, USA
M. HUERTA
Affiliation:
Israel Defence Force Medical Corps, 19 Izmargad Street, Hod Hasharon 45045, Israel
M. MIMOUNI
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of General Paediatrics and Emergency Medicine, Schneider Children's Medical Centre of Israel, 14 Kaplan Street, Petah Tiqva 49100, Israel
D. COHEN
Affiliation:
Israel Defence Force Medical Corps, 19 Izmargad Street, Hod Hasharon 45045, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
G. ROBIN
Affiliation:
Israel Defence Force Medical Corps, 19 Izmargad Street, Hod Hasharon 45045, Israel
S. PITLIK
Affiliation:
Department of Internal Medicine C, Rabin Medical Centre, Beilinson Campus, 39 Jabutinski Street, Petah Tiqva 49100, Israel
M. S. GREEN
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Ministry of Health, the Israel Centre for Disease Control (ICDC), Gertner Institute, Chaim Sheba Medical Centre, Tel Hashomer 52621, Israel
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Abstract

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Clinical descriptions of Epstein–Barr virus (EBV) positive infectious mononucleosis (IM) are rare and their results are inconsistent. Over a 4-year period, we prospectively studied 590 young adults with clinically suspected IM, all of whom were tested for the presence of EBV IgM antibodies. We investigated the demographical, clinical and laboratory features of subjects with positive EBV IgM serology and heterophile antibodies. Contrary to previous studies, we found a seasonal disease pattern with a peak incidence during summer months, and a lower-than-expected prevalence of lymphadenopathy (88·9%), leucocytosis (46·2%), atypical lymphocytosis (89·2%) and elevated liver enzymes (57·9%). The prevalence of hyperbilirubinemia was relatively high (14·9%). The classic triad of fever, sore throat and lymph-adenopathy had relatively low sensitivity (68·2%) and specificity (41·9%) for EBV infection. Our study provides a complete and updated description of the clinical and laboratory presentation of laboratory confirmed IM, which is important for both clinicians and epidemiologists.

Type
Research Article
Copyright
© 2003 Cambridge University Press
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