Purpose: Besides hepatitis with viruses A, B, C, D, E which have the tropism for liver, more
frequently involved in lymphopoiesis organs damage, appear to be infections with Epstein
Barr virus and cytomegalovirus, members of the herpesvirus family, with a prevalence
in adolescents from 50 to 80%. In Epstein Barr virus infection, symptoms vary from
nothing up to fever, superficial and deep lymphadenopathy, moderate hepatitis and
pharyngitis. Cytomegalovirus infection persists long after the initial infection with
reactivation, may develop the symptoms of infectious mononucleosis.
Material and methods: The prospective study included 400 symptomatic patients with fever, respiratory associated
with dyspeptic syndrome and lymphadenopathy. Exclusion criteria were chronic carriers
of the virus. All patients performed both abdominal ultrasound, and lymph nodes (superficial
or deep chains). Doppler ultrasonography was performed abdominal fasting, using a
multifrequency transducers, depending on the size and depth abdomen and neck area
to explore. Biological investigations were monitored: inflammatory, hepatocytolisis
and cholestasis syndromes, blood picture and followed specific antibodies to CMV,
EBV.
Results: The incidence of cases studied were 32% EBV and 12% CMV. We obtained following quantitative
and qualitative ultrasound aspects: morphological and structural changing: mild hepatomegaly
with heterogeneous structure and splenomegaly. In Doppler ultrasound we found increased
velocity in the portal vein than 30 cm/s at all positive patients. Doppler ultrasound
allowed us to identify two main types of lymphadenopathy vascularity: one which has
a single vascular pole thins associated with chronic inflammatory and two with a vascular
pole doubled in diameter and thickness of two or more branches around it, common acute
lymphadenopathy (sensitivity 70%, specificity 85%, p < 0.01).
Conclusion: Doppler ultrasound in infections with CMV and EBV, allowing the establishment of
early diagnostic indicators, may specify lymphadenopathy with hepatomegaly and splenomegaly.
The most significant Doppler changing in infections mononucleosis are: increased velocity
in the portal vein and hepatic arterial flow.
