Abstract：
OBJECTIVE: The use of systemic corticosteroids during Epstein-Barr virus (EBV)-induced infectious mononucleosis is a controversial but widespread practice. We aimed to investigate the frequency of complications in adolescents and adults with infectious mononucleosis in relation to the use of corticosteroids.
METHODS: We reviewed the clinical records of 396 patients admitted to the hospital with infectious mononucleosis (52.0% male; median age, 19 years; range, 15-87 years), with a focus on both short-term (infectious and non-infectious) and long-term (hematological malignancies) complications in relation to corticosteroid use.
RESULTS: A total of 155 (38.6%) patients received corticosteroids at some point during infectious mononucleosis. Corticosteroid use was significantly (P≤0.002) associated with sore throat, lymphadenopathy, leukocytosis, and with antibiotics use (mainly indicated after suspicion of tonsillar bacterial superinfection). Overall, 139/155 (89.7%) patients who were treated with corticosteroids also received antibiotics either before or during hospitalization, compared with 168/241 (69.7%) patients who did not. The frequency of short-term severe complications, either infectious (peritonsillar-parapharyngeal abscess or bacteremia) or non-infectious (splenic rupture, severe thrombocytopenia, myopericarditis, or lymphocytic meningitis) were similar in patients receiving and not receiving corticosteroids. After a median of 15 years of follow-up, only one Hodgkin\'s lymphoma was diagnosed, in a patient who was not treated with corticosteroids during infectious mononucleosis.
CONCLUSIONS: The use of systemic corticosteroids during EBV-induced infectious mononucleosis is generally safe, at least with concomitant antibiotic therapy. However, this should not encourage the use of corticosteroids in this context, given that their efficacy has yet to be demonstrated.
METHODS: We reviewed the clinical records of 396 patients admitted to the hospital with infectious mononucleosis (52.0% male; median age, 19 years; range, 15-87 years), with a focus on both short-term (infectious and non-infectious) and long-term (hematological malignancies) complications in relation to corticosteroid use.
RESULTS: A total of 155 (38.6%) patients received corticosteroids at some point during infectious mononucleosis. Corticosteroid use was significantly (P≤0.002) associated with sore throat, lymphadenopathy, leukocytosis, and with antibiotics use (mainly indicated after suspicion of tonsillar bacterial superinfection). Overall, 139/155 (89.7%) patients who were treated with corticosteroids also received antibiotics either before or during hospitalization, compared with 168/241 (69.7%) patients who did not. The frequency of short-term severe complications, either infectious (peritonsillar-parapharyngeal abscess or bacteremia) or non-infectious (splenic rupture, severe thrombocytopenia, myopericarditis, or lymphocytic meningitis) were similar in patients receiving and not receiving corticosteroids. After a median of 15 years of follow-up, only one Hodgkin\'s lymphoma was diagnosed, in a patient who was not treated with corticosteroids during infectious mononucleosis.
CONCLUSIONS: The use of systemic corticosteroids during EBV-induced infectious mononucleosis is generally safe, at least with concomitant antibiotic therapy. However, this should not encourage the use of corticosteroids in this context, given that their efficacy has yet to be demonstrated.
摘要：
目的：在EB病毒（EBV）引起的传染性单核细胞增多症中使用全身性皮质类固醇是一个有争议但普遍的做法。我们旨在调查与使用皮质类固醇有关的青少年和成人传染性单核细胞增多症的并发症频率。
方法：我们回顾了396例住院的传染性单核细胞增多症患者的临床记录（52.0％为男性；中位年龄，19年；范围，15-87岁），重点关注与使用皮质类固醇有关的短期（感染性和非感染性）和长期（血液恶性肿瘤）并发症。
结果：共有155名（38.6%）患者在传染性单核细胞增多症期间的某个时间点接受皮质类固醇治疗。使用皮质类固醇与喉咙痛显著相关（P≤0.002），淋巴结病，白细胞增多,并使用抗生素（主要表示怀疑扁桃体细菌重叠感染后）。总的来说,139/155（89.7％）接受皮质类固醇治疗的患者在住院前或住院期间也接受了抗生素治疗。与168/241（69.7%）没有这样做的患者相比。短期严重并发症的发生频率，感染性（扁桃体-咽旁脓肿或菌血症）或非感染性（脾破裂，严重的血小板减少症,心肌心包炎,或淋巴细胞性脑膜炎）在接受和未接受皮质类固醇的患者中相似。经过15年的平均随访，只有一个霍奇金淋巴瘤被诊断出来,在传染性单核细胞增多症期间未接受皮质类固醇治疗的患者中。
结论：在EBV引起的传染性单核细胞增多症中使用全身性皮质类固醇通常是安全的，至少伴随抗生素治疗。然而,这不应该鼓励在这种情况下使用皮质类固醇，鉴于其功效尚未得到证明。
方法：我们回顾了396例住院的传染性单核细胞增多症患者的临床记录（52.0％为男性；中位年龄，19年；范围，15-87岁），重点关注与使用皮质类固醇有关的短期（感染性和非感染性）和长期（血液恶性肿瘤）并发症。
结果：共有155名（38.6%）患者在传染性单核细胞增多症期间的某个时间点接受皮质类固醇治疗。使用皮质类固醇与喉咙痛显著相关（P≤0.002），淋巴结病，白细胞增多,并使用抗生素（主要表示怀疑扁桃体细菌重叠感染后）。总的来说,139/155（89.7％）接受皮质类固醇治疗的患者在住院前或住院期间也接受了抗生素治疗。与168/241（69.7%）没有这样做的患者相比。短期严重并发症的发生频率，感染性（扁桃体-咽旁脓肿或菌血症）或非感染性（脾破裂，严重的血小板减少症,心肌心包炎,或淋巴细胞性脑膜炎）在接受和未接受皮质类固醇的患者中相似。经过15年的平均随访，只有一个霍奇金淋巴瘤被诊断出来,在传染性单核细胞增多症期间未接受皮质类固醇治疗的患者中。
结论：在EBV引起的传染性单核细胞增多症中使用全身性皮质类固醇通常是安全的，至少伴随抗生素治疗。然而,这不应该鼓励在这种情况下使用皮质类固醇，鉴于其功效尚未得到证明。
