False dual infection of Epstein-Barr virus and cytomegalovirus in children with infectious mononucleosis

Objective The aim of this study was to explore the characteristics of children with IM suspected for false dual infection of EBV/CMV and the early identification of false positive CMV-IgM through the characteristics of IM.Method The characteristics of 13 patients with IM suspected for the false dual infection of EBV/CMV were retrospectively analyzed and compared with the EBV infection cases and the confirmed dual infection cases of EBV and CMV,respectively.Results ① Clinical manifestations:there were no statistical significance of the duration of fever and the incidence of hepatomegaly and splenomegaly between the false dual infection group and the EBV infection group (P ＞ 0.05),but the anomalies in these two groups were significantly lower than that in the dual infection group (P ＜ 0.05 or P ＜ 0.01).Similar results were seen in the comparison of the complications,including anemia and pneumonia,between these groups.②Laboratory findings:there were no statistical significance of the rate of atypical lymphocyte and the incidence of abnormal liver function between the false dual infection group and the EBV infection group (P ＞0.05),but the anomalies in these two groups were significantly lower than that in the dual infection group (P ＜ 0.05 or P ＜ 0.01).Conclusions CMV-IgM test maybe false positive in some cases with IM in the early stage of disease.A definite diagnosis of false dual infection of EBV/CMV can be established by the continuous detection of antibodies against EBV and CMV during follow-up.The cases with dual infection of EBV/CMV often manifest as more severe symptoms.Therefore,early identification of false positive CMV-IgM can be made through the observation of characteristics of IM. Key words: Herpesvirus 4, human;  Cytomegalovirus ;  Infection;  Infectious mononucleosis