Clinical features of Epstein-Barr virus infection in children aged 0-3 years

Abstract

Introduction. Epstein-Barr virus (EBV), or human herpesvirus 4, is a gammaherpesvirus that infects more than 95% of the world's population, most commonly manifesting itself through acute infectious mononucleosis, frequently found in adolescents and young adults. EBV manifests itself through a dual-life cycle, either lifelong latency in circulating memory B lymphocytes or lytic replication in epithelial cells. Classic triad include sore throat, fever, and lymphadenopathy, but the symptoms may vary in children depending on their age. Aim of study. This review aims to describe the clinical features of Epstein-Barr virus in infants and children under the age of 3. Methods and materials. In order to create this review, we used articles that were published between 2020-2023 from sources like ScholarGoogle, NihGov , NCBI, and PubMed. We also used keywords like: “Epstein-Barr virus”, “EBV infection in infants“, ”clinical characteristics“, ”children “, “infants”. Results. By the age of 5, 50 % of the population is already infected with EBV, its prevalence rising in regions with a shakier socioeconomic status. Children under 3 years old infected with EBV might either be asymptomatic or display atypical symptoms that are no different than mild respiratory viral infections. Unlike in older children with classic signs of mononucleosis syndrome, EBV debuts in 50% of cases with rhinitis and cough. The symptoms might be accompanied by dyspnea, eyelid edema, facial puffiness, polyadenopathy. In some cases it might be associated with a symmetric erythematous maculopapular rash and plaques that may persist for 15-50 days (Gianotti-Crosti syndrome). Pseudomembranous tonsillitis appears early in the first 3 days after the onset, possibly resulting from viral-bacterial associations. A fever that is up to 39-40 C and lasts around 2 weeks might also be the only clinical manifestation, being a common cause of hospitalization in young children. It is also important to note that because of its B lymphotropic nature, the reduced clinical manifestations might be explained by the immaturity of the immune system, but also the presence of transplacental immunity. Serological tests are rarely positive and in much lower titers. The evolution of the disease is favorable for complete healing, but the reactivation of the infection during life is not excluded. Conclusion. Primary infection with EBV in children displays different symptoms according to the age of the affected, the classic triad being mostly determined in older children with mild to severe forms, while younger children manifest atypical infections. They are in most cases asymptomatic or suffer from mild forms that might involve some typical signs, but are usually similar to a cold. The prognosis is also favorable. infects more than 95% of the world's population, most comm only manifesting itself through acute infectious mononucleosis, frequently found in adolescents and young adults. EBV manifests itself through a dual-life cycle, either lifelong latency in circul ating memory B lymphocytes or lytic replication in epithelial cells. Classic triad include s ore throat, fever, and lymphadenopathy, but the symptoms may vary in children depending on their age. Aim of study. This review aims to describe the clinical features of Epst ein-Barr virus in infants and children under the age of 3. Methods and materials. In order to create this review, we used articles that were publi shed between 2020-2023 from sources like ScholarGoogle, NihGov, NCB I, and PubMed. We also used keywords like: “Epstein-Barr virus”, “EBV infection in infan ts“, ”clinical characteristics“, ”children “, “infants”. Results. By the age of 5, 50 % of the population is already infe cted with EBV, its prevalence rising in regions with a shakier socioeconomic status. Children under 3 years old infected with EBV might either be asymptomatic or display atypical symptoms that are no different than mild respiratory viral infections. Unlike in older children with c lassic signs of mononucleosis syndrome, EBV debuts in 50% of cases with rhinitis and cough. The sympto ms might be accompanied by dyspnea, eyelid edema, facial puffiness, polyadenopathy. In s ome cases it might be associated with a symmetric erythematous maculopapular rash and plaques th at may persist for 15-50 days (Gianotti-Crosti syndrome). Pseudomembranous tonsillitis appe ars early in the first 3 days after the onset, possibly resulting from viral-bacterial assoc iations. A fever that is up to 39-40 C and lasts around 2 weeks might also be the only clinical manife station, being a common cause of hospitalization in young children. It is also important to not e that because of its B lymphotropic nature, the reduced clinical manifestations might be expla ined by the immaturity of the immune system, but also the presence of transplacental immunit y. Serological tests are rarely positive and in much lower titers. The evolution of the disease is f avorable for complete healing, but the reactivation of the infection during life is not excluded. Conclusion. Primary infection with EBV in children displays differen t symptoms according to the age of the affected, the classic triad being mostly dete rmined in older children with mild to severe forms, while younger children manifest atypical infections. They are in most cases asymptomatic or suffer from mild forms that might involve some typic al signs, but are usually similar to a cold. The prognosis is also favorable.