Clinical analysis of infectious mononucleosis in 70 adult patients

ZHENG Jian-ming; ZHANG Yong-xin

Abstract：Objective To investigare the clinical features of infectious mononucleosis (IM) in adult patients. Methods The clinical data of 70 adult patients with IM, who were hospitalized in Huashan Hospital Affiliated to Fudan University, from Jun. 2006 to Jun. 2012, were analyzed retrospectively. Results IM could occur in adults during the whole year. The average age of the patients was 31.4±13.9 years old, and male patients were slightly more than female patients. All the patients had fever, while 70.0% of them had agina, 68.6% splenomegaly, 65.7% lymph node enlargement, 29.0% skin rash,15.7% hepatomegaly and 11.4% headache. WBC increased in 50.0% of the patients, the proportion of lymphocytes was more than 35% in 81.4% of the patients, the proportion of atypical lymphocytes was more than 30% in 42.9% of the patients, and PLT were normal in 84.3% of the patients. Liver function was abnormal in 92.9% of the patients. ALT level was above 5 times upper normal limit (ULN) in 47.1% of the patients, but TBIL was above 2 times ULN only in 8.6% of the patients. One patient had abnormal renal function. Epstein-Barr virus (EBV) IgM was positive in 50.0% of the patients and EBV IgG was positive in 91.7% of the patients. The median EBV DNA load was 4.1 log 10 copies/ml. The average hospitalization days were 11.6 ±6.8 days. Two patients with chronic active EBV infection were died, and the curative rate was 92.9%. Conclusions IM is a self-limiting disease, and is no need using corticosteroid or antiviral drugs as a rou-tine treatment. Generally, the prognosis of IM is good, but prognosis of chronic active EBV infection is poor.