Pediatria pre prax 5/2005

INFECTIOUS MONONUCLEOSIS

Infectious mononucleosis has been known since the 19th century. 2 684 cases were reported in the year 2004 in the Czech Republic. The most important etiologic agent is Epstein-Barr virus (EBV), infectious mononusleosis syndrome can also be caused by cytomegalovirus (CMV). In clinical picture fever, pseudomembranous tonsillitis, lymphadenopathy and hepatosplenomegaly are the typical signs. Airway obstruction is the most frequent complication but hematological, neurological, cardiac complications and splenic rupture can occur too. Duncan´s syndrome is severe complication. Lymphocytosis in the blood count and hepatopathy are typical findings for infectious mononucleosis. Detection of heterofile antibodies (Paul-Bunnel test, Ericson test) can be used in diagnosis of EBV, in small children with their negative result detection of specific EBV antibodies is necessary. In EBV diagnosis PCR is also possible to use. In diagnosis of CMV the decisive test is detection of specific IgM antibodies.

Keywords: infectious mononucleosis, Epstein-Barr virus, cytomegalovirus, Paul-Bunnel test, Ericson test, specific EBV and CMV antibodies.