ArticleJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy2019
Clinical differentiation of infectious mononucleosis that is caused by Epstein-Barr virus or cytomegalovirus: A single-center case-control study in Japan.
Article in Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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Who cites it
38 citing papers in PubMed, 78 citations in OpenAlex.
- Pharmacokinetics, Safety, and Tolerability of NPC-21, an Anti-Cytomegalovirus Monoclonal Antibody, in Healthy Japanese and White Adult Men: A Randomized, Placebo-Controlled, First-in-Human Phase 1 Study.Clinical pharmacology in drug development · 2022Trial
- "Infectious mononucleosis" flag, high-fluorescence lymphocyte percentage, and platelet-to-lymphocyte ratio as diagnostic and prognostic biomarkers for infectious mononucleosis in Chinese children.Italian journal of pediatrics · 2025Article
- Thrombocytopenia and neutropenia in Epstein-Barr virus infectious mononucleosis: A retrospective cohort study.Biomolecules & biomedicine · 2025Article
- The impact of acute CMV coinfection on the course of EBV hepatitis in children.Clinical and experimental hepatology · 2025Article
- Rare Case of Concomitant Pulmonary Tuberculosis and Cytomegalovirus Infection in an Immunocompetent Patient.Case reports in infectious diseases · 2025Article
- Analysis of clinical characteristics and risk factors of infectious mononucleosis in children with splenomegaly.Frontiers in pediatrics · 2025Article
- Viral infections and immune modulation in bladder cancer: implications for immunotherapy.Exploration of targeted anti-tumor therapy · 2025Review
- Human cytomegalovirus infection-induced lymphocytosis diagnosed by metagenomic next-generation sequencing: a case report and literature review.Frontiers in immunology · 2025Review
- Pelvic inflammatory disease associated with cytomegalovirus infection in an immunocompetent adult: Case report and literature review.Clinical case reports · 2024Article
- A broad wastewater screening and clinical data surveillance for virus-related diseases in the metropolitan Detroit area in Michigan.Human genomics · 2024Article
- Acute Cytomegalovirus Infection Associated With Erythema Multiforme-Like Eruption: A Case Report.Cureus · 2024Article
- Primary Cytomegalovirus Pneumonia Successfully Treated with Corticosteroid Therapy and Valganciclovir.Internal medicine (Tokyo, Japan) · 2024Article
- mRNA vaccine design for Epstein-Barr virus: an immunoinformatic approach.In silico pharmacology · 2024Article
- Cytomegalovirus colitis in immunocompetent hosts: A case report and literature review.Clinical case reports · 2024Article
- Spanish HCMV Seroprevalence in the 21st Century.Viruses · 2023Article
- Elevated Antibody Titers to Epstein-Barr Virus and Cytomegalovirus in Patients with Drug-Induced Lupus.Viruses · 2023Article
- Epstein-Barr virus as a leading cause of multiple sclerosis: mechanisms and implications.Nature reviews. Neurology · 2023Review
- Article
- Coinfection with SARS-CoV-2 and Cytomegalovirus in a Patient with Mild COVID-19.Case reports in infectious diseases · 2023Article
- Development of infectious mononucleosis as an unusual manifestation of COVID-19.Auris, nasus, larynx · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionInfectious mononucleosis (IM) is a common viral infection that typically causes fever, pharyngitis, and lymphadenopathy in young patients. The Epstein-Barr virus (EBV) is the most common cause of IM, followed by cytomegalovirus (CMV). Given that serological testing is associated with limitations regarding its accuracy, availability, and time to receive results, clinical differentiation based on symptoms, signs, and basic tests would be useful. We evaluated whether clinical findings could be used to differentiate EBV-IM from CMV-IM.
methodsIn this single-center retrospective case-control study, we evaluated >14-year-old patients with serologically confirmed EBV-IM or CMV-IM during 2006-2017. We compared the patients' symptoms, physical findings, blood counts, and serum biomarkers to create three regression models: model 1 (symptoms and signs), model 2 (model 1 plus sonographic hepatosplenomegaly and blood counts), and model 3 (model 2 plus hepatobiliary biomarkers).
resultsAmong the 122 patients (72.6%) with EBV-IM and 46 patients (27.4%) with CMV-IM, the median age was 25 years and 82 patients (48.8%) were male. The median age was 10 years older in the CMV-IM group (p < 0.001) and the median interval from onset to visit was 5 days longer in the CMV-IM group (p < 0.001). Logistic regression revealed that EBV-IM was predicted by younger age, short onset-to-visit interval, lymphadenopathy, tonsillar white coat, hepatosplenomegaly, atypical lymphocytosis, and elevations of lactate dehydrogenase and gamma-glutamyl transferase. All regression models had areas under the curve of >0.9.
conclusionHistory and physical findings, especially when used with atypical lymphocytosis and sonographic hepatosplenomegaly, can help physicians differentiate EBV-IM from CMV-IM.
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