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The aim of the study was to determine whether infectious mononucleosis may trigger atopic symptoms or modulate their clinical course. Data from literature point out to such a relationship and attribute it to the influence of EBV on lymphocytes B and IL-4,IL-5,IL-10 and vIL-10 secretion stimulation. The authors examined 30 children who had suffered from symptomatic infectious mononucleosis 2-4 years previously, evaluating symptoms of allergic diseases and performing skin prick tests with selected inhalant and food allergens. The symptoms of atopic disease were found in 57 % in the mononucleosis group, a significantly higher percentage (p<0.0001) than in general population of children in Lódź (16%). The frequency of positive skin prick tests with common allergens was also significantly higher (60% vs 27%, respectively).

Infectious mononucleosis is a self-limiting lymphoproliferative disorder, which contribute to the development of the various clinical symptoms. Exudative tonsillitis was found to be caused by Epstein-Barr virus in 19% of all viral infections and may imitate a bacterial etiology. The aim of this study was to identify the microbes from the nasopharyngeal swabs obtained from the patients with exudative tonsillitis and to assess their susceptibility to antibiotics. The patients were hospitalized as an infectious mononucleosis after unsuccessful antibiotic therapy. 84 patients were investigated: group I--patients with serological positive infectious mononucleosis tests and group II--patients with acute exudative tonsillitis and with serologically excluded infectious mononucleosis. The diagnosis was confirmed clinically, haematologically, biochemically and serologically. Nasopharyngeal specimens were taken, once, at the first day of hospitalization. Then, routine microbiological assays were performed. Isolated strains were identified biochemically: API Strep, API Staph, API E, API Ne, APINH (bioMerieux). The susceptibility to antibiotics with an agar diffusion assay was performed according to Kirby-Bauer. We concluded that various, potentially pathogenic bacterial flora was found in throat during infectious mononucleosis. Haemophilus spp. and Staphylococcus aureus MSSA were isolated more frequently. Haemophilus influence was susceptible to cefotaxime and azytromycine. Candida albicans was isolated in every fourth patient. Streptococcus pyogenes as an etiological agent of exudative tonsillitis was confirmed in the group II. The pharyngeal candidiosis was also observed more frequently in the group II.

Persistent lymphopenia of various intensity has been noted in 45% of persons who had a history of infectIous mononucleosis. The group consisted od 500 patients, (236 males and 264 females). In all of them the diagnosis of mononucleosis had been based on the characteristic clinical signs and symptoms and changes in the blood picture and confirmed by the non-specific and/or specific serologic tests. In 33 persons (10 males and 18 females) the total number of lymphocytes varied from 884 to 992 per 1 cmm, the distribution being as follows: B lymphocytes--146 to 198, CD4--482 to 645 and CD8--245 to 364 per 1 cmm. 18 persons (18 males and 10 females) were given thymosine (TFX) subcutaneously for 30 days in the dose of 0.02 g daily, the remaining 15 (7 males and 8 females) received 3.0 g of isoprinosine per day for the same period. The total lymphocytes count and that of B, CD4 and CD8 was performed before and after the treatment and then followed once a month until 180 days since the treatment had been started. The TFX therapy was repeated after 8-12 months since the end of the first course in 3 patients and that with isoprinosine in 4. The strategy and the examination pattern were the same as before, control examinations being performed every 6 months and final analysis was done after 5 years of follow-up. Among the 33 patients who received immunomodulating treatment, normalisation of the lymphocytes count appeared in 24 (64%). Among the 12 persons with less pronounced lymphopenia, who did not received any treatment, spontaneous normalisation appeared in 5 (40%). It may be therefore assumed, that in persons with the history of infectious mononucleosis with persistent marked lymphopenia, thymosine and isoprinosine may be used in the therapy as additional immunomodulators.

The diagnosis of infectious mononucleosis is usually based on the clinical signs and symptoms, characteristic changes in the peripheral blood picture and the results of specific and non-specific serologic tests. However, despite of these precise diagnostic criteria this disease is often misdiagnosed, misunderstood and therefore treated in a wrong way. Therefore, because of our long lasting clinical experience based on a very large number of cases, we have decided to present the results of our studies on the clinical features of this interesting disease as well as some laboratory findings (serum bilirubin level and AspAt, AlAt, AP and GGTP activity). The analysis of clinical and biochemical markers comprised 500 patients (236 males and 264 females) aged 15-35, in whom mononucleosis had been diagnosed according to the commonly approved criteria. The clinical signs and symptoms appearing during the first week of the disease, the results of the laboratory findings and the therapy are described in detail. It has been stressed, that the diagnosis of mononucleosis should be considered mainly in young patients with fever persistent for over one week accompanied by inflammatory changes in the throat and enlargement of the lymph nodes, liver and spleen and other pathologic signs and symptoms. Blood picture and the results of non-specific and specific serologic tests are helpful in the final diagnosis of this interesting disease.