title: Clinical characteristics and laboratory findings in Danish children hospitalized with primary Epstein-Barr virus infection.
abstract: BACKGROUND
  Epstein-Barr virus (EBV) positive infectious mononucleosis (IM) is a common disease in adolescents. However, IM is often considered a rare disease in early childhood. We aimed to describe the classical presentation of adolescent EBV-associated IM compared to EBV infection at younger age.
  
  
  METHODS
  All immunocompetent children hospitalized at Hvidovre University Hospital, Copenhagen between 2002 and 2013, who presented with clinical features that prompted a laboratory test for EBV, and who tested positive by presence of EBV-specific antibodies, heterophile antibodies or a positive EBV PCR were included (n = 95).
  
  
  RESULTS
  Children aged 1-2 years were the age group most commonly hospitalized with acute EBV infection (27% of the cohort), followed by teenagers aged 14-15 years (23%). Fever, cervical lymphadenopathy, tonsillitis and fatigue were the most common physical findings overall. Dividing the children into three age groups (0-4 years, 5-10 years and 11-15 years) revealed that the oldest age groups significantly more often suffered from headache, tonsillitis, sore throat, abdominal pain and nausea. Young children typically presented with a runny nose, fever, fatigue and cervical adenitis. Compared with children under 5, children aged 5-15 years more often showed lymphocytosis (84% vs 62%), elevated alanine aminotransferase (77% vs 33%) and lactate dehydrogenase (79% vs 44%).
  
  
  CONCLUSIONS
  EBV infection is common in young children, and children less than 3 years of age constitute the largest group of hospitalizations for acute EBV infection. EBV-associated IM should be suspected in febrile children of all ages with tonsillitis, lymphadenopathy, lymphocytosis and elevated liver enzymes.
authors: a From the Department of Paediatrics , Hvidovre University Hospital , Copenhagen , Denmark.
authors: Sofie Kathrine
authors: SK
authors: Topp
authors: a From the Department of Paediatrics , Hvidovre University Hospital , Copenhagen , Denmark.
authors: Vibeke
authors: V
authors: Rosenfeldt
authors: b Statens Serum Institut, Department of Microbiological Diagnostics and Virology , Division of Diagnostics and Infection Control, State University Hospital , Copenhagen , Denmark.
authors: Hanne
authors: H
authors: Vestergaard
authors: c Department of Clinical Microbiology , Rigshospitalet, State University Hospital , Copenhagen , Denmark.
authors: Claus Bohn
authors: CB
authors: Christiansen
authors: a From the Department of Paediatrics , Hvidovre University Hospital , Copenhagen , Denmark.
authors: Marie-Louise
authors: ML
authors: Von Linstow
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D005260:Female; D005334:Fever / Q000209:etiology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology; D006760:Hospitalization; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D007244:Infectious Mononucleosis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D008099:Liver / Q000737:chemistry; D008206:Lymphatic Diseases / Q000821:virology; D008218:Lymphocytosis / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction
chemical_list: D000914:Antibodies, Viral
keywords: Children; Epstein-Barr virus; age; mononucleosis; symptoms