{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:19:27Z","timestamp":1784647167649,"version":"3.55.0"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Guangdong High-level Hospital Construction Fund","award":["LCYJ2022076"],"award-info":[{"award-number":["LCYJ2022076"]}]},{"name":"Guangdong High-level Hospital Construction Fund","award":["SZGSP012"],"award-info":[{"award-number":["SZGSP012"]}]},{"name":"Guangdong High-level Hospital Construction Fund","award":["SZSM202311024"],"award-info":[{"award-number":["SZSM202311024"]}]},{"name":"Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties","award":["LCYJ2022076"],"award-info":[{"award-number":["LCYJ2022076"]}]},{"name":"Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties","award":["SZGSP012"],"award-info":[{"award-number":["SZGSP012"]}]},{"name":"Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties","award":["SZSM202311024"],"award-info":[{"award-number":["SZSM202311024"]}]},{"name":"Sanming Project of Medicine in Shenzhen","award":["LCYJ2022076"],"award-info":[{"award-number":["LCYJ2022076"]}]},{"name":"Sanming Project of Medicine in Shenzhen","award":["SZGSP012"],"award-info":[{"award-number":["SZGSP012"]}]},{"name":"Sanming Project of Medicine in Shenzhen","award":["SZSM202311024"],"award-info":[{"award-number":["SZSM202311024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Objectives: Our objective was to investigate the clinical characteristics, complications, and treatment outcomes of Epstein\u2013Barr virus (EBV)-related infectious mononucleosis (IM) in children and to identify risk factors associated with prolonged fever and abnormal liver function. Methods: This retrospective study included 3006 children admitted to Shenzhen Children\u2019s Hospital from May 2009 to April 2024 with suspected EBV-related IM. After excluding cases without etiological evidence and those with underlying diseases, 2660 cases were analyzed. Data on demographics, clinical manifestations, laboratory findings, complications, and treatment outcomes were collected. Logistic regression was used to identify risk factors for prolonged fever and abnormal liver function. Results: Among the 2660 confirmed cases, patients ranged from 8 months to 17 years of age, with a median age of 4 years and a male-to-female ratio of 1.46:1. Co-infections were identified in 369 (13.9%) patients, predominantly with Group A Streptococcus. Complications occurred in 560 (24.46%) of the 2289 patients without co-infections, with bronchitis being the most common (42.68%). Elevated ferritin and atypical lymphocyte percentage were associated with prolonged fever (p &lt; 0.001), while elevated lactate dehydrogenase (LDH) and a lower CD4% predicted abnormal liver function (p &lt; 0.001). Antiviral therapy did not shorten fever duration or hospital stay but prolonged both when combined with corticosteroids or intravenous immunoglobulin (IVIG) (p &lt; 0.001). Conclusions: Specific laboratory markers such as ferritin, atypical lymphocyte percentage, LDH, and CD4% are important predictors of prolonged fever or liver dysfunction in EBV-IM. Our findings suggest that antiviral therapy may not be beneficial in uncomplicated cases and highlight the need for tailored treatment strategies to optimize patient outcomes.<\/jats:p>","DOI":"10.3390\/pathogens14070702","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T08:24:17Z","timestamp":1752654257000},"page":"702","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Retrospective Review of Children Hospitalized for Epstein\u2013Barr Virus-Related Infectious Mononucleosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Shufeng","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjun","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing\u2019an District, Shanghai 200040, China"},{"name":"Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai 200052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5180-5568","authenticated-orcid":false,"given":"Qingluan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing\u2019an District, Shanghai 200040, China"},{"name":"Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai 200052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengrui","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchun","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing\u2019an District, Shanghai 200040, China"},{"name":"Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai 200052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiexin","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Longhua Branch of Shenzhen People\u2019s Hospital, Shenzhen 518109, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing\u2019an District, Shanghai 200040, China"},{"name":"Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai 200052, China"},{"name":"Institute of Infection and Health, Fudan University, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyun","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Urumqi Middle Road, Jing\u2019an District, Shanghai 200040, China"},{"name":"Shanghai Sci-Tech Inno Centre for Infection and Immunity, Room 201, No. 6, Lane 1220, Huashan Road, Changning District, Shanghai 200052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jikui","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Shannon-Lowe, C., and Rickinson, A. 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