Grotto I, Mimouni D, Huerta M, Mimouni M, Cohen D, Robin G, Pitlik S, Green M S
Israel Defense Force Medical Corps, 19 Izmargad Street, Hod Hasharon 45045, Israel.
Epidemiol Infect. 2003 Aug;131(1):683-9. doi: 10.1017/s0950268803008550.
Clinical descriptions of Epstein-Barr virus (EBV) positive infectious mononucleosis (IM) are rare and their results are inconsistent. Over a 4-year period, we prospectively studied 590 young adults with clinically suspected IM, all of whom were tested for the presence of EBV IgM antibodies. We investigated the demographical, clinical and laboratory features of subjects with positive EBV IgM serology and heterophile antibodies. Contrary to previous studies, we found a seasonal disease pattern with a peak incidence during summer months, and a lower-than-expected prevalence of lymphadenopathy (88.9%), leucocytosis (46.2%), atypical lymphocytosis (89.2%) and elevated liver enzymes (57.9%). The prevalence of hyperbilirubinemia was relatively high (14.9%). The classic triad of fever, sore throat and lymph-adenopathy had relatively low sensitivity (68.2%) and specificity (41.9%) for EBV infection. Our study provides a complete and updated description of the clinical and laboratory presentation of laboratory confirmed IM, which is important for both clinicians and epidemiologists.
爱泼斯坦-巴尔病毒（EBV）阳性传染性单核细胞增多症（IM）的临床描述很少见，且结果不一致。在4年的时间里，我们对590名临床疑似IM的年轻人进行了前瞻性研究，所有受试者均检测了EBV IgM抗体的存在情况。我们调查了EBV IgM血清学和嗜异性抗体阳性受试者的人口统计学、临床和实验室特征。与先前的研究相反，我们发现该病呈季节性发病模式，夏季发病率最高，且淋巴结病（88.9%）、白细胞增多（46.2%）、非典型淋巴细胞增多（89.2%）和肝酶升高（57.9%）的患病率低于预期。高胆红素血症的患病率相对较高（14.9%）。发热、咽痛和淋巴结病这一经典三联征对EBV感染的敏感性（68.2%）和特异性（41.9%）相对较低。我们的研究提供了实验室确诊IM的临床和实验室表现的完整且最新的描述，这对临床医生和流行病学家都很重要。
