Clinical and Laboratory Evaluation of Infants and Children With Epstein - Barr Virus - Induced Infectious Mononucleosis : Report

Previous studies in Ghana and the United States have shown that the great majority of primary Epstein-Barr virus (EBV) infections in infants remain silent and fail to evoke hematologic and heterophil antibody responses typical of infectious mononucleosis (lM). In the present study. a search was made for cases of IM among children less than age 49 mo and a diagnosis of this disease was made in 32 patients. The great majority had fever. tonsillar pharyngitis. prominent cervical lymphadenopathy. and respiratory symptoms. There were significant differences in serologic responses between the 1 1 infants and toddlers aged 10-24 mo and 21 young children aged 26-48 mo. In particular. heterophil antibody responses were detected in only 3 of 1 1 infants (27.3%) compared with 1 6 (76.2%) of 21 children. The infants also had less prominent viral capsid antigen (VCA) specific 1gM antibody responses (63.6% versus 100%) and a lower frequency of peak lgG