World scientific research journal
https://scientific-jl.com/wsrj
Volume-39_Issue-1_May-2025
90
UDC: 616.216.1-002.3-08
CLINICAL CHANGES IN CHILDREN WITH INFECTIOUS
MONONUCLEOSIS: AN ANALYSIS
Keldiyorova Zilola Doniyorovna
keldiyorova.zilola@bsmi.uz
https://orcid.org/0000-0002-0662-5787
Bukhara State Medical Institute named after Abu Ali Ibn Sina
Abstract:
Thus, the early days of infectious mononucleosis are characterized by
fever, signs of intoxication, clear damage to the mouth and throat in the form of
angina, and difficulty breathing through the nose, along with enlargement of the liver
and spleen. These signs allow for a presumptive diagnosis to be made early in the
course of the disease. In the acute phase of the disease, hyperthermia persists,
symptoms of tonsillitis decrease, hepatomegaly intensifies, and clinical blood tests
show an increase in ESR, leukocytosis, lymphocytosis, and the appearance of atypical
mononuclear cells in 52% of cases. Complications developed in 27.4% of cases.
Keywords:
hyperthermia, tonsillitis, hepatomegaly, atypical mononuclear cells.
Relevance:
Despite numerous scientific studies dedicated to investigating
infectious mononucleosis, this disease remains a relevant issue. This is primarily due
to the high incidence rate, for example, in Uzbekistan, it is 7.5 per 100,000, while
among children it reaches 34 per 100,000.
Globally, among herpes viruses, Epstein-Barr virus and one of its most
widespread forms, infectious mononucleosis, hold a significant position, as
recognized by researchers. Epstein-Barr virus is known for its multiple mechanisms
of immunosuppression, with the “host” organism being less susceptible to immune
system effects. However, this results in an increase in immune system dysfunctions
and the formation of chronic viral infections. Research has shown that the impact of
this virus on the immune system is explained by the cessation of natural interferon
production and blocking apoptosis mechanisms, leading to the development of
secondary immunodeficiencies, which can contribute to the formation of autoimmune
diseases
and
tumor
processes
in
genetically
predisposed
individuals.
The clinical manifestations of infectious mononucleosis in children are diverse, which
creates difficulties in making timely and accurate diagnoses, as well as issues related
to differential diagnostics. Diagnostic errors in the pre-hospital stage can account for
40-90% of cases, especially among younger children. The discovery of more
convenient diagnostic methods (such as immunoassays to detect virus antigens and
molecular biology methods like polymerase chain reaction, which can identify
various DNA viruses in biological samples) has enabled better understanding of the
World scientific research journal
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Volume-39_Issue-1_May-2025
91
clinical presentation, diagnostic methods, and immune-pathogenesis of EBV-induced
mononucleosis,
as
well
as
the
pathogenic
treatment
strategies.
Objective of the Study:
Considering the above, we conducted a detailed analysis of the clinical course
of infectious mononucleosis and its age-related characteristics.
Materials and Methods:
Data from 120 children aged 3 to 18 years, diagnosed and treated for infectious
mononucleosis during 2019-2022, were analyzed. This group formed the primary
cohort of the study, and a control group of 40 children was also assessed. All children
in the study underwent clinical, laboratory, biochemical, virological, and
immunological tests. The analysis focused on their complaints, underlying diseases,
premorbid conditions, causes of the disease, disease duration, nutrition, and the
effectiveness of early treatment measures.
According to the study results, 500 children with infectious mononucleosis were
retrospectively analyzed, with 120 of them included in the prospective analysis as the
main cohort. Of these, 59 (49.1%) were from rural areas, and 61 (50.9%) were from
urban areas.
Results:
In terms of age distribution, the children were grouped as follows:
Group 1: 3 to 7 years old – 34 children (28.3%)
Group 2: 8 to 12 years old – 70 children (58.3%)
Group 3: 13 to 18 years old – 16 children (13.4%)
Table 1:
Distribution of children based on age and gender is shown in the
material. The gender distribution revealed that 65% of the children were male, and
35% were female.
Figure 1:
Age and gender distribution of children with infectious
mononucleosis. In all age groups, a higher proportion of the affected children were
male, although the reason for this remains unclear and may be related to the biological
gender characteristics of children’s organisms.
Temperature Reaction:
At the time of hospital admission, the temperature in the affected children varied
significantly by age.
In 60 (51.4%) children, the temperature was above 38°C.
In 48 (40%) children, a subfebrile temperature (37-38°C) was recorded.
In only 16 (10%) children, the temperature reached 37°C.
Table 2:
Temperature variation in children with infectious mononucleosis by
age.
Table 3:
Distribution of children’s temperature and age during admission.
In all age groups, the majority of the children (58.4%) had temperatures above 37°C,
indicating the organism’s response to infection.
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Premorbid Conditions and Nutrition:
Among the 120 children, 114 (95.0%) had anemia, with rickets (34.1%),
hypotrophy (23.3%), exudative-catarrhal diathesis (20.8%), and low birth weight
(15.8%) being the most common comorbid conditions.
Figure 3:
Distribution of nutrition types among children with infectious
mononucleosis.Regarding nutrition, 27.2% of the children were exclusively
breastfed, 30.7% were artificially fed, and 42.1% had mixed feeding. Children with
insufficient or artificial feeding were found to have worse outcomes.
Clinical Course:
All children (100%) experienced a typical (manifest) course of the disease. The
severity of the disease varied:
13.4% had a mild form,
70% had a moderate form, and
16.6% experienced a severe form of the disease.
Conclusion:
The clinical course of infectious mononucleosis in children varies
significantly, and timely diagnosis and pathogenetic treatment are crucial in managing
the disease and preventing complications.
References:
1.
Ruzhentsova T.A., Khavkina D.A., Chukhlyaev P.V. Criteria for Differential
Diagnosis of Measles at the Prehospital Stage.
Lechashchiy Vrach.
2017;11:40–
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2.
Shamsheva O.V. Measles Vaccination in the Modern Era.
Pediatrics. G.N.
Speransky Journal.
2013;92(1):22–26.
3.
Kankasova M.N., Mikhova O.G., Pozdeeva O.S. Infectious Exanthems in
Children.
Practical Medicine.
2015;7:26–31.
