Çocuk Enfeksiyon Hastalıkları Polikliniğine Başvuran Enfeksiyöz Mononükleoz Tanısı Alan Hastaların Değerlendirilmesi

Yıl 2018, Cilt: 18 Sayı: 1, 19 - 23, 01.04.2018

Osman Vural Özge Metin Akcan Derya Arslan Muhammet Yaşar Kılınç Murat Sütçü

https://doi.org/10.5222/j.child.2018.16023

Öz

Amaç: Bu çalışmada enfeksiyöz mononükleoz tanısı alan çocukların klinik, laboratuvar ve radyolojik özelliklerinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Ocak 2015-Şubat 2016 tarihleri arasında, semptom ve klinik bulguları ile enfeksiyöz mononükleoz düşünülen ve anti-VCA IgM pozitif olan hastalar dâhil edildi. Çalışmaya bu kriterleri sağlayan 58 hasta alındı. Hasta dosyalarından vakaların yaş, cinsiyet, yakınma ve süresi, fizik muayene bulguları ve laboratuvar sonuçları kaydedildi. Bulgular: Vakaların 34’ü %58.6 erkek olup, erkek/kız oranı 1.4 idi. Hastaların yaş ortalaması 67.3±40.9 ay idi. Başvurularında hastaların çoğunun birden fazla yakınması mevcuttu. En sık belirtilen yakınma %72.4 boyunda şişlik olup bunu; ateş %51.7 ve boğaz ağrısı %44.8 izlemekteydi. Bu hastaların 45’inde %77,5 lenfadenopati mevcuttu. Bu bulguyu tonsiller hipertrofi 35, %60.3 , splenomegali 20, %34.4 , membranoz tonsillit 15, %25.9 , hepatomegali 12, %20.6 ve döküntü 10, %17.2 takip ediyordu. VCA IgM pozitifliği ile birlikte hastaların %17.2’sinde EBNA IgG ve %68.6’sında ise VCA IgG pozitifliği saptandı. Polikliniğimize başvurmadan önce hastaların 28’inin %48.2 bir antibiyotik tedavisi kullandığı öğrenildi. Hastaların 10’unda %17.3 döküntü olup, 3’ünde döküntünün antibiyotik kullanımı sonrası geliştiği belirlendi.Sonuç: Enfeksiyöz mononükleoz, klasik bulguların dışında farklı klinik bulgulara neden olabilir. Birçok viral ya da bakteriyel enfeksiyon tablosu ve malignitelerle karışabileceğinden ayırıcı tanıda düşünülmelidir

Anahtar Kelimeler

Çocuk, enfeksiyöz mononükleoz, EBV

Evaluation of The Patients who Applied to the Pediatric Infectious Diseases Department and Received the Diagnosis of Infectious Mononucleosis

Öz

Objective: The aim of this study is to evaluate the clinical, laboratory and radiological findings of patients diagnosed with infectious mononucleosis.Material and Method: Fifty-eight patients who had been diagnosed with infectious mononucleosis according to symptoms and clinical findings in addition to anti viral capsid antigen immunoglobulin M anti-VCA IgM positive results between January 2015, and February 2016 were included in this study. Demographic and clinical data age, gender, presenting symptom and duration, physical examination findings and results of laboratory tests were gathered from patients’ files.Results: Thirty-four cases 58.6% were male and the male / female ratio was 1.4. The mean age of the children was 67.3±40.9 months. Most of the patients had more than one presenting symptom. The most common symptoms in order of decreasing frequency were swelling in the neck 72.4% , followed by fever 51.7% and sore throat 44.8% . Forty - five patients 77.5% had lymphadenopathy. The other findings were tonsillar hypertrophy n=35, 60.3% , splenomegaly, n=20, 34.4% , membranous tonsillitis n=15, 25.9% , hepatomegaly n=12, 20.6% and rash n=10, 17.2% . In addition to anti VCA-IgM positiviy; 17.2%of the patients also had EBNA IgG and 68.9 % had VCA IgG- positive results. Twenty- eight patients 48.2% were given antibiotherapy prior to admission in our outpatient clinic. Ten patients 17.3% had rash, and 3 5.1% of them it developed after previous antibiotherapy.Conclusion: Infectious mononucleosis may cause several clinical symptoms other than classical findings. Since it may be confused with manifestations of many viral or bacterial infection, and malignancies, it should be considered in differential diagnosis

Anahtar Kelimeler

Child, infectious mononucleosis, EBV

Kaynakça

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