CLINICAL COURSE OF CHRONIC EPSTEIN-BARR VIRUS INFECTION IN CHILDREN OF PRESCHOOL AGE
DOI:
https://doi.org/10.11603/1681-2727.2024.1.14288Keywords:
Epstein-Barr virus infection children, child, preschool, lymphadenopathyAbstract
SUMMARY. Сlinical features of chronic Epstein-Barr virus infection (EBVI) in preschool children are described. Cytomegalovirus (CMV) and human herpes virus type 6 (HHV-6) infections were also detected.
The aim is to study the features of chronic EBVI clinical manifestations in the reactivation stage and frequency of coinfection with CMV and HHV-6 in preschool children.
Patients and methods. The main group included 40 children aged 3–6 years, infected with EBV, with recurrent respiratory infections, recurrent tonsillitis, with one or more manifestations: lymphadenopathy, fever, nasal breathing difficulty, hypertrophy of the palatine tonsils. The control group included 20 EBV-infected healthy children aged 3-6 years. Antibodies antiVCA IgM, antiEBNA IgG, anti CMV IgM and IgG were detected by ELISA. DNA of EBV, CMV and HHV-6 was detected by PCR in blood and oropharyngeal smear.
Results. Viral replication in the blood was detected in 25 % of cases. In such patients fever, enlargement of the posterior and anterior cervical lymph nodes up to 2–2.5 cm, hypertrophy of the palatine tonsils, hypertrophy of the nasopharyngeal tonsil, hepatomegaly, and post-viral fatigue syndrome were more often detected. Severe lymphadenopathy, adenoid hypertrophy, and the frequency of acute respiratory infections 8–10 per year correlate with virus replication in the blood. In children of the main group, EBV DNA was detected in oropharyngeal smear in 67.5 % of cases, CMV DNA in 15 %, and HHV-6 DNA – in 37.5 %.
Conclusions. In children with chronic EBVI, viraemia was detected in 25 % of cases, and EBV on the tonsils – in 67.5 %. In children with viremia fever, cervical lymphadenopathy, 2–3 grade hypertrophy of the palatine tonsils and 2–3 grade adenoids were detected, frequency of acute respiratory infections was 8–10 times per year, tonsillitis – 4–6 times per year. In children without viremia, lymphadenopathy and tonsillar hypertrophy was less expressed, the incidence of respiratory infections and tonsillitis is lower. Frequency of EBV associated with CMV is 90 %, and with HHV-6 – 95.9 %.
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