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Epstein-Barr virus (EBV) guidance

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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:

  • Full Blood Count
  • Liver Function Tests
  • Any other investigations deemed clinically appropriate

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.

Editorial Information

Last reviewed: 05 June 2018

Next review: 05 June 2021

Author(s): Dr Rosie Hague

Version: 2.2

Approved By: Paediatric & Neonatal Clinical Risk & Effectiveness Committee