Comprehensive insights into pediatric infectious mononucleosis: a retrospective study

Chen Wang; Saeed Saboor; Yiyang Zhang; Gang Li; Chunming Jiang

doi:10.3855/jidc.21351

Comprehensive insights into pediatric infectious mononucleosis: a retrospective study

Authors

Chen Wang The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People’s Hospital, Hangzhou, Zhejiang Province, China https://orcid.org/0009-0003-9514-7303
Saeed Saboor School of Medicine, Zhejiang University, Hangzhou, China https://orcid.org/0000-0002-7183-0082
Yiyang Zhang The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China https://orcid.org/0009-0005-5900-2996
Gang Li Medical College of Nantong University, Nantong, Jiangsu Province, China https://orcid.org/0009-0004-7134-8909
Chunming Jiang Department of Pediatrics, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang Province, China

DOI:

https://doi.org/10.3855/jidc.21351

Keywords:

children, infectious mononucleosis, Epstein Barr virus, liver damage, clinical features, retrospective

Abstract

Introduction: The objectives of this study were to identify clinical and laboratory markers of infectious mononucleosis (IM) in children, investigate the risk factors for liver damage and prolonged hospitalization, and enhance Epstein-Barr virus (EBV) diagnostic precision.

Methodology: This retrospective study analyzed 288 pediatric IM cases hospitalized from January 2023 to December 2024. Clinical features, laboratory parameters, and EBV-DNA loads were evaluated using statistical analyses to identify predictors of disease severity and outcomes.

Results: Among the 288 children (median age: 5 years; 48.3% male), fever, cervical lymphadenopathy, creatine kinase (CK), IgM, and CD4/CD8 ratios were significantly associated with high EBV-DNA load. Liver damage (35.1% of cases) correlated with age, splenomegaly, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH), ferritin, and immune markers (p < 0.05). Prolonged hospitalization was associated with hepatomegaly, ALT, AST, GGT, LDH, and ferritin levels (p < 0.05). Multivariate analysis identified fever as a predictor of high EBV-DNA load; while age, LDH, and ferritin were independent risk factors for liver damage. Hepatomegaly was a key predictor of extended hospitalization (p < 0.05).

Conclusions: IM predominantly affected children aged 3–7 years in Hangzhou. Fever predicted high EBV-DNA load, while elevated LDH, ferritin, and hepatomegaly signaled increased risks of liver damage and prolonged hospitalization, informing more precise management strategies.

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Published

2025-09-30

How to Cite

Wang C, Saboor S, Zhang Y, Li G, Jiang C (2025) Comprehensive insights into pediatric infectious mononucleosis: a retrospective study. J Infect Dev Ctries 19:1359–1369. doi: 10.3855/jidc.21351

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Issue

Vol. 19 No. 09: September 2025

Section

Original Articles

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