Abstract
Introduction: Epstein-Barr virus is a known cause of childhood cervical lymphadenopathy. In practice this infection is not sought as a cause in low-resources settings. The virus among children with cervical lymphadenopathy was not studied before in this country. The aims of this study were to estimate the prevalence of primary EBV infection and to describe clinical characteristics of children presenting with cervical lymphadenopathy.
Materials and Methods: A cross-sectional study was conducted among children presented with cervical lymphadenopathy to Khartoum Children Emergency Hospital during the period from February 2009 to January 2010. Eighty-two children were randomly selected. Demographic and clinical datawere recorded. Routine laboratory values were determined and children's sera were analysed for anti-viral capsid antigens IgM Epstein-Barr virus ELISA tests. Mean and SD were calculated. Regression analysis was to identify association between demographic, clinical and laboratory variables and IgM seropositivity of EBV.
Results: Epstein-Barr virus infection was diagnosed in 13 (15.9%) children with cervical adenopathy (n=82). The average age of these children was 7.5 (SD +/- 3.3) years. The male to female ratio was 1.6. The most frequent symptoms were fever, loss of appetite and cough. The anterior cervical group of lymph nodes was most commonly implicated. All affected patients had mobile lymph nodes and the majority, 12 (92.3%), of patient had firm nodes. The lymph node number ranged from 2-6 nodes; with a mean of 3.5 nodes and average size of 3.6 cm. Splenomegaly and pharyngo-tonsillitis were found in 30.8% and 23.1 % of patients respectively and leukocytosis was noted in 3 (23.1 %). The odds of IgM seropositivity decreased with age < 9 years (OR 0.15, 95% Cl 0.03-0.78, p=0.023).
Conclusion: EBV infection is not an uncommon cause of childhood cervical lymphadenopathy. The commonest symptoms are fever, loss of appetite and cough. Anterior cervical nodes are the most affected. Younger children (age < 9 years) are less likely to be sero-positive.