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Investigation and destination for the management of EBV - primary care follow-up, secondary are follow-up or hospital admission.
Children presenting with suspected or confirmed EBV.
Medical and nursing staff who see acutely unwell children and young people.
Epstein-Barr virus is a common infection in childhood which, in the large majority of cases, is experienced as a mild/sub-clinical infection. However, in a small minority of cases, it can produce life threatening complications; even in children previously assumed to be immunocompetent.
Acute EBV infection can cause aseptic meningitis, encephalitis, hepatitis, myocarditis, orchitis, cytopenias, lymphoproliferation and splenic rupture.
In a child where a diagnosis of EBV has been made and who presents to hospital with compatible clinical symptoms, the following minimum investigations should be undertaken:
If evidence of EBV induced anaemia, leucopenia, thrombocytopenia, deranged liver function tests, significant splenomegaly or organ dysfunction is found on clinical assessment, then the child should be discussed with and follow-up arrangements made by, the receiving consultant/MAU consultant.
If the child is assessed as well enough to go home without these signs/investigation results, then GP follow-up should be arranged.
If a child is assessed to be unwell enough to warrant admission as a result of EBV infection, an ID opinion should be sought.
Last reviewed: 05 June 2018
Next review: 05 June 2021
Author(s): Dr Rosie Hague
Approved By: Paediatric & Neonatal Clinical Risk & Effectiveness Committee