Epstein–Barr virus infection in children presenting with acute cervical lymphadenopathy

Abstract

Introduction: The aim of this study was to estimate the prevalence of Epstein–Barr virus (EBV) infection among children presenting with acute cervical lymphadenopathy and describe the clinical characteristics of children with primary EBV-induced cervical lymphadenopathy. Materials and Methods: This was a prospective observational study in a tertiary care hospital. Results: Twenty-two children out of 127 patients evaluated had primary EBV infection among children presenting with acute cervical lymphadenopathy. The most common symptoms noted were fever (95.5%), loss of appetite (63%), and sore throat (45.5%). Posterior and anterior cervical lymph nodes (99.5% and 86.4%) were most commonly affected with a frequency of 2–6 nodes (mean of 3 nodes) and an average size of 2.4 cm (range: 2–6 cm). Maculopapular, nonpruritic rash was noted in 27.3% and Hoagland sign in 9.1% of cases. Hepatomegaly and clinical splenomegaly were noted in 81% and 59%, respectively, among EBV-positive patients. Conclusion: EBV primary infection is a common cause of acute cervical lymphadenopathy among Indian children with EBV responsible for approximately 17% of such clinical presentation. A high index of clinical suspicion and timely diagnosis of EBV in these children will be useful in limiting investigations and avoidable use of antibiotics by clinicians in such presentation.