{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:29:16Z","timestamp":1787318956133,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Acute Epstein\u2013Barr virus (aEBV) and cytomegalovirus (CMV) infections frequently have similar manifestations. We aim to evaluate the characteristics of aEBV infection, risk factors for hospitalisation and differences according to CMV IgM detection (EBV\u2010CMV co\u2010detection) in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective, single\u2010centre study including patients &lt;16\u2009years diagnosed with aEBV infection (positive anti\u2010EBV IgM\/Paul\u2010Bunnell test and acute symptomatology). EBV\u2010CMV co\u2010detection was defined as positive CMV IgM. Factors associated with age, hospitalisation and EBV\u2010CMV co\u2010detection were analysed in a multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 149 patients were included (median age 4.6\u2009years). Most frequent manifestations were fever (77%), cervical lymphadenopathy (64%) and elevated liver enzymes (54%). Younger children had lower rate of positive Paul\u2010Bunnell test (35% vs. 87%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), but higher rate of EBV\u2010CMV co\u2010detection (54% vs. 29%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). These children tended to have less typical symptoms of infectious mononucleosis and higher hospitalisation rate. The overall antibiotic prescription was 49%. Hospitalisation (27 children; 18%) was independently associated with prior antibiotic therapy and anaemia. Sixty\u2010two cases (42%) had EBV\u2010CMV co\u2010detection, which was independently associated with elevated liver enzymes and younger age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, younger children with aEBV infection presented more frequently with atypical clinical symptoms, had higher EBV\u2010CMV co\u2010detection rates and were more often hospitalised. Hospitalisation was associated with prior antibiotic prescription.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.16760","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T05:48:18Z","timestamp":1679291298000},"page":"1287-1295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute Epstein\u2013Barr virus infection: Diagnostic challenge in young children, risk factors for hospitalisation and cytomegalovirus co\u2010detection"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-260X","authenticated-orcid":false,"given":"Ana","family":"Guti\u00e9rrez\u2010V\u00e9lez","sequence":"first","affiliation":[{"name":"Neonatology Department Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Castro\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Jov\u00e9\u2010Blanco","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Aguilera\u2010Alonso","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Complutense University  Madrid Spain"},{"name":"CIBERINFEC  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Mar\u00eda","family":"Rinc\u00f3n\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Complutense University  Madrid Spain"},{"name":"CIBERINFEC  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Hernanz\u2010Lobo","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Complutense University  Madrid Spain"},{"name":"CIBERINFEC  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Navarro\u00a0G\u00f3mez","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Complutense University  Madrid Spain"},{"name":"CIBERINFEC  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Hern\u00e1ndez\u2010Sampelayo","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Department of Pediatrics Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Complutense University  Madrid Spain"},{"name":"CIBERINFEC  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Alonso\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Saavedra\u2010Lozano","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Department of 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