INFECTIOUS MONONUCLEOSIS

Objective. To study the clinical and laboratory features of infectious mononucleosis caused by viruses of various etiologies. Patients and methods. A prospective observational study covering the analysis of 123 cases of infectious mononucleosis was conducted at the Novgorod Regional Infectious Diseases Hospital and the Regional Children's Clinical Hospital. Etiological decoding of infectious mononucleosis was carried out by detecting antibodies and genomic material to various types of herpes viruses. Results. Infectious mononucleosis is a polyetiological disease, in the etiological structure the largest proportion belongs to the Erstein-Barr virus. This disease most often develops in preschool age (38,2%) and primary school age (30,1%). In most patients, infectious mononucleosis was moderate (91,9%), severe course was observed in 8,13% of cases, which was associated with mixed infection and with pronounced cytolytic syndrome. Clinically, the disease was characterized by the development of febrile fever and severe intoxication (100%), as well as multiple organ damage: lymphadenopathy (91,9%), tonsillitis (72,4%), hepatomegaly (63,4%), splenomegaly (52,03%), exanthema (14,6%), jaundice (7,32%). Laboratory-specific changes in the hemogram (94,3%): leukocytosis up to 15-30×109/l and higher (53,7%); neutrophilia (53,7%), presence of atypical mononuclear cells more than 10% (62,6%); high erythrocyte sedimentation rate up to 20-30 mm/h and high level of CRP in 41,5% of patients; moderate decrease in platelet count (38,2%). In the biochemical blood test: increase in ALT (60,9%), in some cases the level of transaminases was significant up to 10-15 N; hyperbilirubinemia with an increase in both fractions of bilirubin (7,32%).