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With the aim of the optimization of the differential diagnosis there was performed an assessment of cellular immunity in patients with acute viral (infectious mononucleosis associated with Epstein-Barr virus) and acute bacterial infection (bacterial tonsillitis). Study groups was consisted of 22 patients with infectious mononucleosis, the comparison group - 19 patients with acute bacterial tonsillitis. There was revealed a number of significant changes typical for acute infectious process of various etiology. The features of cellular immunity in acute viral infection in terms of EBV-associated infectious mononucleosis are: the increase of cytotoxic CD8(+) - T-cells; consistent deficiency ofpopulations and subpopulations of CD19 (+) - B lymphocytes; a significant increase in density (MFI) expression of CD19-, CD21-, CD81-receptors in various subpopulations ofB lymphocytes. Revealed regularities of changes in cellular immunity in acute Epstein-Barr virus infection are caused by biological characteristics of the pathogen and can be used for the optimization of the laboratory diagnosis of infectious mononucleosis.