Risk factors for pneumonia in children with Epstein-Barr virus infectious mononucleosis / 中华实用儿科临床杂志

ABSTRACT

Objective@#To investigate the risk factors for pneumonia in children with Epstein-Barr virus (EBV) infectious mononucleosis(IM).@*Methods@#The clinical data of children with EBV-IM from March 2015 to February 2018 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed.The patients were divided into a pneumonia group and a non-pneumonia group.The difference between 2 groups was analyzed, including gender, age, duration of fever, the maximum temperature in disease duration, the size of liver, the size of spleen, tonsillopharyngitis, cervical lymphadenopathy, edema of the eyelids, white blood cell (WBC), lymphocyte, atypical-lymphocytes, C-reactive protein (CRP), procalcitonin (PCT), alanine transaminase (ALT), glutamic oxalacetic transaminas (AST), lactic dehydrogenase (LDH), cytomegalovirus (CMV) antibody, the titer of mycoplasma (MP) antibody, EBV DNA, length of stay, and hospitalization expenses.The single factor analysis was performed to analyze the above data between 2 groups, and the data with statistical significance were analyzed by the multifactor Logistic regression.The recei-ver operator characteristic (ROC) curve was drawn to evaluate the predicting ability of the indicators for IM combined with pneumonia.@*Results@#Among 923 cases, 133 cases(14.4%) EBV-IM patients were complicated with pneumonia.The findings of single factor analysis indicated that the risk factors were the duration of fever, the size of liver, the size of spleen, and the titer of MP antibody (all P<0.05). The multifactor Logistic regression showed that the duration of fever, the size of liver, the titer of MP antibody were the risk factors for EBV-IM children with pneumonia (P=0.013, 0.028, 0.014). The area under curve (AUC) of the duration of fever was 0.624, and the critical value was 7.5 d (P=0.000); the AUC of the size of liver was 0.590, and the critical value was 2.65 cm (P=0.003).@*Conclusions@#The incidence rate of EBV-IM children combined with pneumonia was high.With the presence of the titer of MP antibody ≥1∶160, the duration of fever≥7.5 days, and the size of liver>2.65 cm, it may be independent risk factors for pneumonia in IM children with EBV infection, which requires special attention clinically and earlier chest imageological examination are needed.