OTOLARYNGOLOGIC CLINICAL-PATTERNS IN PEDIATRIC INFECTIOUS-MONONUCLEOSIS

Purpose: Classic infectious mononucleosis (IM) is uncommon in children ; therefore, the incidence of severe pharyngotonsillitis complicating the infection is not well established. This study was undertaken to be tter define the management of complications with special emphasis on t he use of parenteral steroids and the role and timing of surgical mana gement. Materials and Methods: A retrospective review of all cases of IM encountered between January 1989 through December 1993 was undertak en. Results: There were 109 patients admitted with IM. Sixty patients (55%) were admitted for severe pharyngotonsillitis. Twenty-nine patien ts in this subgroup were felt to have symptoms of severe upper airway obstruction and were treated with parenteral steroids. Surgical interv ention was required in three patients. Conclusion: The study shows a h igher incidence of admissions for severe pharyngotonsillitis complicat ing IM than reported in the adult literature. It suggests that routine use of parenteral steroids is indicated in cases of severe upper airw ay obstruction and may decrease the need for surgical intervention. Co pyright (C) 1996 by W.B. Saunders Company.