<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462024000500272</article-id>
<article-id pub-id-type="doi">10.24875/bmhim.24000027</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Exploring atypical manifestations and multisystem involvement of Epstein-Barr virus infection in hospitalized pediatric patients from Mexico: insights from a tertiary hospital (2012-2022)]]></article-title>
<article-title xml:lang="es"><![CDATA[Explorando las manifestaciones atípicas y el compromiso multisistémico de la infección por el virus de Epstein-Barr en pacientes pediátricos hospitalizados de México: perspectivas de un hospital de tercer nivel (2012-2022)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salinas-Nuñez]]></surname>
<given-names><![CDATA[Laura E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pacheco-Rosas]]></surname>
<given-names><![CDATA[Daniel O.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Olais]]></surname>
<given-names><![CDATA[José H.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendoza-Coronel]]></surname>
<given-names><![CDATA[Elizabeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Robles-Ramírez]]></surname>
<given-names><![CDATA[Roberto J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bonifaz]]></surname>
<given-names><![CDATA[Laura C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fuentes-Pananá]]></surname>
<given-names><![CDATA[Ezequiel M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Departamento de Infectología, Hospital de Pediatría "Dr. Silvestre Frenk Freund"]]></institution>
<addr-line><![CDATA[ Ciudad de México]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Infantil de México "Federico Gómez" Unidad de Investigación en Virología y Cáncer ]]></institution>
<addr-line><![CDATA[ Ciudad de México]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI División de Auxiliares de Diagnóstico y Tratamiento, Hospital de Pediatría "Dr. Silvestre Frenk Freund"]]></institution>
<addr-line><![CDATA[ Ciudad de México]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Coordinación de investigación en salud]]></institution>
<addr-line><![CDATA[ Ciudad de México]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2024</year>
</pub-date>
<volume>81</volume>
<numero>5</numero>
<fpage>272</fpage>
<lpage>279</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462024000500272&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462024000500272&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462024000500272&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Epstein-Barr virus (EBV) infection, with a global prevalence exceeding 95%, typically manifests in children as infectious mononucleosis. However, clinical practice frequently encounters diverse atypical presentations characterized by multisystem involvement, often resulting in an unfavorable clinical course. Our objective is to describe the clinical manifestations and results of EBV infection in a tertiary pediatric hospital in Mexico.  Method: An observational, transversal, retrospective, and descriptive study that included a systematic review of medical records (2012-2022) of patients under 18 years of age with detectable EBV particles in peripheral blood.  Results: The study included 26 patients with a median age of 5 years and a male predominance of 53.8%. Predominant symptoms were fever (85%) and lymphadenopathy (35%). Sixty-five percent had severe and atypical manifestations, including pneumonia and hepatic, hematologic-oncologic, and autoimmune diseases. Anemia, thrombocytopenia and leukopenia were common, with lymphocytosis in 19% of cases. The median EBV viral load was 2816 copies/mL (range: 555-355,500 copies/mL). Four deaths related to EBV infection were reported. Viral load in these cases also varied widely from 594 to 121,000 copies/mL. Supportive care was administered to 85% of patients, while others received antiviral treatment, steroids, and rituximab.  Conclusion: Atypical manifestations were common, especially in children with multisystem involvement. EBV should be considered as a potential contributor to a diverse spectrum of clinical presentations, emphasizing the need for comprehensive evaluation and awareness in clinical diagnosis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: La infección por el virus de Epstein-Barr (VEB) tiene una prevalencia mundial superior al 95%. Se considera que en los niños se manifiesta principalmente como mononucleosis infecciosa; sin embargo, en la práctica clínica, a menudo encontramos numerosas manifestaciones atípicas con compromiso multisistémico que llevan a un curso desfavorable. Nuestro objetivo es describir las manifestaciones clínicas y los resultados de la infección por VEB en un hospital pediátrico de tercer nivel en México.  Método: Estudio observacional, transversal, retrospectivo y descriptivo, en el cual se revisaron sistemáticamente los expedientes médicos de pacientes menores de 18 años con una detección positiva de partículas de VEB en sangre periférica en el periodo 2012-2022.  Resultados: Se incluyeron 26 pacientes con una mediana de edad de 5 años y predominio de varones (53.8%). El 65% presentaron manifestaciones graves y atípicas, incluyendo enfermedades respiratorias, hepáticas, hematooncológicas y autoinmunitarias. Los síntomas más frecuentes fueron fiebre (85%) y linfadenopatía (35%). El 54% presentaron manifestaciones atípicas, incluyendo linfohistiocitosis hemofagocítica, neumonía y neoplasia. La anemia, la trombocitopenia y la leucocitopenia fueron comunes, mientras que el 19% presentaron linfocitosis. La media de la carga viral fue de 2816 copias/ml (555-355,500). Se informaron cuatro muertes atribuidas a la infección por VEB, con valores de carga viral de 594 a 121,000 copias/ml. El 85% de los pacientes recibieron solo tratamiento sintomático, mientras que otros recibieron antivirales, esteroides y rituximab.  Conclusión: Las manifestaciones atípicas se observaron comúnmente, en especial en niños con compromiso multisistémico. El VEB debe considerarse como un potencial factor contribuyente en el diagnóstico de una amplia gama de manifestaciones clínicas.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Epstein-Barr virus]]></kwd>
<kwd lng="en"><![CDATA[Infectious mononucleosis]]></kwd>
<kwd lng="en"><![CDATA[Hemophagocytic lymphohistiocytosis]]></kwd>
<kwd lng="en"><![CDATA[Tertiary-level hospital]]></kwd>
<kwd lng="en"><![CDATA[Multisystem disease]]></kwd>
<kwd lng="en"><![CDATA[Atypical manifestations]]></kwd>
<kwd lng="es"><![CDATA[VEB]]></kwd>
<kwd lng="es"><![CDATA[Mononucleosis infecciosa]]></kwd>
<kwd lng="es"><![CDATA[Hemofagocitosis linfohistiocítica]]></kwd>
<kwd lng="es"><![CDATA[Hospital de tercer nivel]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad multisistémica]]></kwd>
<kwd lng="es"><![CDATA[Manifestaciones atípicas]]></kwd>
</kwd-group>
</article-meta>
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<surname><![CDATA[Napoleón]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Antonio]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Georgina]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Características clínicas y paraclínicas de la mononucleosis infecciosa por virus de Epstein-Barr en 162 pacientes en el instituto Nacional de Pediatría, 1970-2011]]></article-title>
<source><![CDATA[Rev Enferm Infecc Pediatr]]></source>
<year>2011</year>
<volume>25</volume>
<page-range>50-6</page-range></nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lozano]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<source><![CDATA[Descripción de las Manifestaciones Clínicas de Pacientes con Infección por Virus de Epstein-Barr en el Servicio de Pediatría del Hospital General "Dr. Manuel Gea González"de 2016 a 2018]]></source>
<year>2020</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Nacional Autonoma de México]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
