Clinical and laboratory «masks» of acute forms of infectious mononucleosis in children and adolescents at various stages of the diagnostic process

Abstract

Infectious mononucleosis at various stages of the pathological process and depending on the severity, presence of complications is characterized by polymorphism of the clinical features, which greatly complicates its early diagnosis.Features of the course, clinical manifestations of acute infectious mononucleosis in 55 children and adolescents aged 1 to 14 years, at various stages of the diagnostic process were analyzed. Common combination of clinical syndromes, which allows to suspect the presence of infectious mononucleosis, were identified.To establish the diagnosis of infectious mononucleosis, an integrated approach is required, taking into account the dynamics of the disease during the first week of the disease, the dataof laboratory and instrumental studies.Infectious mononucleosis is distinguished by the polymorphism of the clinical picture, depending on the prevalence of general inflammatory syndrome, endotoxicosis syndrome, lymphoproliferative, hepatolienal and other syndromes, as well as its complicated and uncomplicated course. Most often at the prehospital stage, the “masks” of MI were: acute respiratory viral infection (43.8 ± 7.16 %), acute allergic reaction (35.4 ± 6.9 %), acute community­acquired pneumonia (16.7 ± 5.38 % of cases), follicular and lacunar tonsillitis (8.3 ± 3.98 %).Diagnosis of MI is also difficult due to the rather late (on the second week of the disease) appearance of atypical mononuclear cells in the peripheral blood of patients, with a parallel long­term absence of clinical symptoms sufficient for the diagnosis of infectious mononucleosis in 41.7 ± 7.12 % of patients.