Mononucleosis in adults, treatment of infectious mononucleosis in adults. Symptoms and treatments for mononucleosis in adults Infectious disease mononucleosis in adults

Mononucleosis is defined as an acute or chronic viral pathology. The disease is provoked by a specific Epstein-Barr virus (a type of herpetic agent). According to medical statistics, only 20% of the viral infection occurs in acute forms of mononucleosis, while in the remaining 80% of clinical cases, chronic mononucleosis is observed in adults and children. We are talking about the latent course of an infectious disease, when the disease manifests itself sluggishly from the very beginning. In most cases, this indicates that the immune system is coping with the agent.

Probable factors in the development of the disease

The disease develops as a result of two main factors. First of all, it is necessary that the infection enters the body. Considering that 95% of people are infected with the Epstein-Barr virus, it can be argued with a high degree of probability that this factor is present in everyone. The second necessary factor is a decrease in the efficiency of the immune system.

There are several ways of transmitting a viral agent:

Airborne route. The Epstein-Barr infectious agent is transmitted by coughing, sneezing, with particles of saliva. For infection, it is enough to be near an infected person for some time. At the same time, the carrier himself may not suspect that he is dangerous to others (you can get infected from him, while he himself does not get sick).
contact path. The pathogen is transmitted through physical contact. Another name for acute and chronic mononucleosis is kissing disease. Transmission through sexual contact is also possible. Therefore, adults are more likely to suffer from the described ailment.
Household path. It has much in common with the contact form of infection. Infection occurs when interacting with household items used by a sick person: towels, combs, hygiene products (toothbrushes, etc.).
transmission path. It occurs relatively rarely. However, if the recipient is not infected, the likelihood of the virus entering the body with blood from the donor is high.
Finally, it is possible for the agent to enter the human body when passing through the birth canal from a pregnant mother to a child. This is one of the most common ways infection spreads.
Alimentary (fecal-oral) route. It is extremely rare. It has no significant epidemiological significance.

Even being a carrier of the Epstein-Barr agent, the patient does not always suffer from mononucleosis. This means that the disease is not directly transmitted from person to person, only a pathogenic virus passes. A person, being only a carrier all his life, may never get sick. In other cases, the course of the pathological process is so poor that there are practically no characteristic signs.

Symptoms

Unlike the acute form of the disease, when the symptoms do not leave the slightest doubt, in the chronic course, there may be signs in a latent form. This means that the symptomatology is present, but its intensity is so small that the patient does not attach any great importance to his condition. Typical manifestations include:

The incubation period of the disease is about 2-3 weeks. After the specified period in the chronic phase, mild hyperthermia is observed at the level of subfebrile values (not higher than 37.2-37.5 degrees). The patient feels weakness, drowsiness, slight malaise. Since the signs are nonspecific, a person takes them for a common cold.
Next comes the sore throat. They are weak, aching, pulling. In the morning, a small amount of yellowish or greenish lumpy pus may be discharged from the lacunae. Purulent plugs go away (lumps with a sharp unpleasant, putrid odor). These are symptoms of tonsillitis.
The cervical and sublingual lymph nodes become inflamed. However, lymphadenitis also proceeds sluggishly. Instead of a rise in temperature, hyperemia and the formation of a characteristic nodular formation, everything is limited to a slight pulling pain when chewing, talking, trying to move the neck or tongue. On palpation, enlarged lymphatic structures can be detected.
Formed pathological rashes on the skin. They may look like spots, papules, dots, hemorrhages. However, unlike acute mononucleosis, when the rashes are massive, in the chronic course of the disease, we are talking about single or focal small defects on the skin (in the face or neck, chest or arms).
Nasal congestion develops, the expiration of a small amount of mucus from the nasal passages. The voice becomes hoarse, weak. Perhaps the formation of a cough reflex without sputum discharge. This is the so-called pharyngitis.

There are no characteristic lesions of the gastrointestinal tract, lungs with the formation of pneumonia and other changes. The disease disappears on its own after 5-7 days. The question arises: is it possible to get mononucleosis again after suffering an illness? However, it is not entirely correct. The Epstein-Barr virus, like its "relatives" of the herpetic type, is highly virulent, so a cure never occurs. Especially when it comes to the chronic form of the process. There are frequent relapses. Moreover, each repeated round of the disease may be different from the others. As soon as the immune system fails, the pathology appears before the patient "in all its glory" with lesions of the lungs, gastrointestinal tract, massive rashes, respiratory disorders and other manifestations. This is the case when, as they say, "once at a time is not necessary." To prevent the disease from recurring, you need to follow the rules of prevention.

Diagnostic measures

Diagnosis of mononucleosis is the task of an infectious disease specialist or therapist. At the initial consultation, the specialist conducts an oral questioning of the patient and collects an anamnesis. This is not enough, because the symptoms are not specific enough. The chronic form of the disease, especially if the course of the process is mild, is difficult to diagnose. It is important to suspect the probable nature of the pathology in a timely manner and begin treatment. Otherwise, time will be lost and the disease will start to recur again. This is a matter of expert experience. Specific tests are assigned:

General blood test. The analysis formula reveals atypical mononuclear cells, a large number of lymphocytes, leukocytosis, and an increase in the erythrocyte sedimentation rate.
Tests for specific antibodies to the Epstein-Barr virus are prescribed. They make it possible to determine whether the process is fresh, how long ago the infection occurred, how effectively the immune system copes with the pathogen.
PCR, ELISA. They make it possible to detect the presence of traces of virus DNA in the blood.
Serological studies.

To exclude a secondary lesion and staging the process, radiography of the lungs, ultrasound examination of the abdominal cavity are shown. These studies are sufficient to establish and confirm the diagnosis, as well as prescribing adequate treatment.

Treatment

There are no specific methods for the treatment of mononucleosis, both acute and chronic. Symptomatic treatment is prescribed, as well as restorative therapy. The use of medicines of the following pharmaceutical groups is shown:

Anti-inflammatory drugs of non-steroidal origin for the relief of inflammatory processes in organs and tissues. Ketorolac, Nimesulide, Nise, Ibuprofen, Nurofen and others.
Analgesics for pain relief. You can use drugs based on metamizole sodium: Baralgin, Analgin, combined medicines.
Antipyretics based on paracetamol and ibuprofen.
Specific antibacterial drugs. Selected only by a doctor. Additionally, they help prevent secondary infection.
Antiherpetic drugs for topical treatment of the nasopharynx and upper respiratory tract.
Antiseptic drugs to eliminate focal manifestations of the throat and other structures of the nasopharynx.

A diet high in protein, low in fast carbohydrates is mandatory. Frequent and fractional meals are shown. You can not physically overwork, bed rest is required.

The consequences of mononucleosis can be the most complex and controversial: there may be disturbances in the functioning of the liver, lymphoid tissue and the entire lymphatic system, lungs, and cardiovascular system.

Prevention

There are no specific preventive measures. You need to keep your immune system strong. For these purposes, the following activities are assigned:

hardening with a contrast shower;
proper nutrition. The diet should be sufficiently fortified, maximum plant foods and lean meat, as little as possible fast food, fatty meats, fried, smoked and salted;
quitting smoking and alcohol abuse. These factors undermine the body's defenses.

Chronic mononucleosis appears to be a serious and insidious disease. It often recurs, gives many complications, develops gradually, over the years, sometimes not making itself felt until the immune system weakens. In order to cope with this scourge, you need to go to the doctor at the first sign of malaise so as not to waste time. This is the most correct solution.

Other studies, such as ultrasound or x-rays, may be needed to diagnose complications that have developed. It is important to remember that the disease is easier to treat if it is diagnosed in a timely manner.

That is why, when the first symptoms of mononucleosis appear, it is important to immediately seek help from a doctor. Only timely treatment will avoid the chronicity of the disease and the occurrence of complications.

Treatment of infectious mononucleosis

In the event that a patient has infectious mononucleosis in an uncomplicated form, then all medical procedures are carried out at home. At the same time, he needs, for the duration of the disease, to compose his diet according to the rules of diet No. 5:

increase the intake of fiber, lipotropic substances, pectins;
drink more fluids;
all dishes are steamed, boiled or baked;
eat only warm dishes;
products rich in cholesterol, essential oils, oxalic acid are excluded.

Of the general activities, it is important to observe a half-bed rest and try to avoid hypothermia. It is very important to ventilate the room frequently.

From drug therapy, there are:

antiviral agents;
means for lowering body temperature;
steroid therapy according to indications;
the introduction of immunoglobulins;
antihistamines;
solutions for irrigation of the pharynx.

It should be noted that a specific therapy for infectious mononucleosis, that is, a vaccine, is under development and is unlikely to be put into use in the near future.

Despite its apparent simplicity, infectious mononucleosis is a very serious disease that requires a responsible approach. So, it is very important to promptly seek help from a specialist who knows exactly the symptoms and treatment of mononucleosis in adults. Only the early start of therapeutic measures will prevent the development of complications and will make it possible to cope with the disease as quickly as possible.

A disease such as mononucleosis in adults is rare. Usually, after the age of forty, the risk of catching this virus decreases, since the body is already producing resistant by this time. But still there are cases of infection. What are the symptoms of mononucleosis in adults? How and how to treat the disease?

What is this disease

Infectious mononucleosis in adults is an anthroponotic infectious disease caused by the Epstein-Barr virus. The disease is also called glandular fever or monocytic.

The virus is able to stay in the human body for a long time without any manifestations. In this case, the patient is a carrier of the virus and a dangerous source of infection. The duration of the incubation period is 30-50 days. At the end of this period, the virus is most actively shed. The virus has different ways of penetration:

When kissing with saliva, viruses enter the oral cavity, and microscopic drops of sputum and saliva enter during or sneezing;
During the use of hygiene items and cutlery;
During sexual intercourse;
Through the placenta from mother to her child;
Through poorly processed syringes and instruments.

Important! All people who surround the patient are already at risk.

The reasons

After entering the human body through the respiratory system, the virus infects the mucous membrane of the mouth and throat. B-lymphocytes under the influence of infection begin to multiply actively, which leads to the formation of atypical mononuclear cells. In the future, they, together with the blood flow, reach the tonsils, liver, spleen, and also the lymph nodes. The patient may develop a fever and present with symptoms similar to those of a cold. In this case, swelling of the lymphatic tissue is considered characteristic. The virus remains in the body forever, having a negative effect on the body at times of weakening.

Usually the disease is most often activated in the autumn-spring period. Children and teenagers suffer from it. Newborns get sick much less often. After infection, almost every patient develops a strong immunity to infection.

Symptoms

There are signs that most often appear when infected with a virus:

Damage to the oral cavity and pharynx. As a result of the inflammatory process, there is an increase in the tonsils and palate, which leads to difficulty breathing, squeezing the voice and characteristic wheezing sounds. At the same time, there is no discharge of mucus from the nose. This condition is explained by the fact that during infection, inflammation of the mucous membrane of the lower part of the nasal concha (the so-called posterior) occurs. Some patients still experience thick mucous discharge, redness of the posterior pharyngeal wall, and swelling.
Plaque. In almost 85% of those infected, a continuous plaque on the palatine and nasopharyngeal tonsils is observed in the first days. After a while, its number decreases. At the same time, when a plaque appears, the patient's temperature rises to 39-40 * C.
Enlargement of the spleen and liver. The organ reaches its maximum size after 4-10 days from the onset of the disease. In some patients, the sclera and skin turn yellow. At the end of the peak period of the disease, these signs gradually disappear. In some cases, an increase in the organ lasts up to three months.
Skin rashes. During the period of active development of the disease, a hemorrhagic, urticarial, scarlatino- and measles-like rash may appear. Point hemorrhages occur in the oral cavity in the region of the sky.
The cardiovascular system. There are systolic murmurs, a decrease in heart sounds.

After 2-3 weeks, the symptoms of mononucleosis subside and disappear, but atypical mononuclear cells can be detected in the blood for a long time. When infected with the virus in childhood, the prognosis is favorable. Things are a little more complicated with adult patients.

The symptomatic manifestation of chronic mononucleosis is most often explained by a general decrease in immunity. This can be provoked by frequent stressful conditions, as well as prolonged use of medications.

The chronic form of the disease is characterized by:

Not too pronounced enlargement of the spleen;
Inflammation of the liver (;
Normal or subfebrile temperature;
Increased fatigue, weakness;
Drowsiness or sleep disturbance;
Pain in the muscles;
Migraine;
Periodically there is nausea and vomiting;
A rash with mononucleosis is observed on the lips and genitals (sometimes throughout the body).

In the photo you can see the manifestation of a rash during the period of mononucleosis.

Important! Some experts believe that the infectious mononucleosis virus is the cause of the development of CFS (Chronic Fatigue Syndrome).

Consequences of mononucleosis

Why is viral mononucleosis dangerous? With timely and high-quality treatment, the disease soon recedes. In this case, complications may not appear, and the person completely returns to normal life. But in especially difficult cases, the disease can take a chronic form and even end in the death of the patient. The most common cause of this is rupture of the spleen.

The following complications after mononucleosis are distinguished:

Blockage of the upper respiratory tract as a result of high swelling of the tonsils;
transverse myelitis;
Myocarditis;
Paralysis;
Guillain-Bare syndrome;
Hemolytic and aplastic;
(interstitial).

The virus often infects the patient's nervous system. As a result of this, paralysis of facial muscles occurs, as well as polyneuritis, psychosis,.

Important! With timely access to a specialist, all complications and negative consequences of a viral disease can be avoided. The attending physician will be able to determine the severity of the disease and prescribe an effective treatment.

Diagnostics

Before starting the treatment of mononucleosis in adults, it is necessary to carefully analyze all the symptoms and conduct a series of studies. The complexity of diagnosing lies in the fact that the disease has some signs characteristic of other diseases.

For proper diagnosis, the following tests are necessary:

Scraping from the mucous membrane inside the cheeks and PCR blood examination;
Laboratory determination of Epstein-Barr virus antigens;
Serological examination of blood for the detection of antibodies to mononucleosis;
chest x-ray;
Ultrasound of the abdominal cavity;
Examination for (with an acute form of the disease).

A general blood test should be done for mononucleosis in order to clarify the severity of the pathology. In addition to consulting an infectious disease specialist, you will need to consult a surgeon,.

Features of treatment

If the disease proceeds in a mild or moderate form, then therapy can be carried out even at home according to the tactics developed by the doctor. In this case, the patient is advised to adhere to bed rest and proper diet. With the manifestation of an acute form of infection, treatment should be carried out in a hospital under the supervision of specialists and regular blood monitoring. Upon completion of treatment therapy, a six-month rehabilitation will be required. During this period of time, the patient is monitored by a therapist, an infectious disease specialist and other doctors (depending on the symptoms of the disease and its severity). In order for the recovery of the patient's body to be more effective, stressful conditions and physical exertion should be avoided.

Medical therapy

Treatment of infectious mononucleosis in adults is carried out in combination:

It is necessary to rinse the mouth and pharynx daily with antiseptic agents (furatsilin, iodonol);
Apply drugs that help relieve swelling from the tonsils, for example, claritin, peridol, suprastin;
If there is a high body temperature, then it is recommended to use an antipyretic (ibuprofen, ibuklin);
When a bacterial infection is attached, antibacterial drugs (erythromycin, amoxicillin) are prescribed;
Glucocorticosteroids are prescribed if there are problems with breathing (prednisolone,);
Antiviral drugs (, viferon);
Vasoconstrictor (naphthyzinum);
necessary to strengthen the improvement of the body's defenses (immunal,);
Vitamin and mineral complexes are necessary to restore and strengthen the body after an illness;
To maintain the liver appoint Essentiale Forte, antral.

To eliminate the manifestations of angina, antibiotics and probiotics are prescribed. Antibiotic therapy is reduced to taking the following drugs: cephalosporin, sumamed. Probiotics include hilak forte, linex. If there are no bacterial complications, then these remedies should not be used.

In addition to the fact that the patient must be treated with medication, his diet should be changed. The mononucleosis diet includes foods such as:

Fish;
Cottage cheese;
Kefir;
Boiled lean meat;
Vegetable light soups;
Fresh vegetables and fruits;
Compotes, juices (non-acidic) and teas;
Kashi.

Diet food completely excludes the use of alcohol, coffee, pickled and smoked foods, as well as salty and fried foods.

Folk ways

You can get rid of the unpleasant symptoms of mononucleosis with the help of alternative medicine. Treatment of mononucleosis in adults is carried out using the following herbal decoctions:

Mix the following herbs in equal amounts: edelweiss, cornflower flowers, elecampane, chicory, burdock root. Brew 3 tbsp. crushed mixture in a liter of boiling water. After insisting the broth for 12 hours, strain well. Take half a glass 30 minutes before meals. The course of treatment should not exceed two months. A decoction will help relieve the manifestations of the disease and enhance the effectiveness of drug treatment.
A decoction of chamomile flowers, calendula, coltsfoot, immortelle, succession and yarrow will help cure the disease.
Crushed astragalus root (1 tbsp) brew in a glass of boiling water. Then insist in a thermos for 2 hours. Take before meals.

Prevention

To prevent the disease, the following recommendations should be followed:

Wash your hands as often as possible;
Do not share cutlery;
Do not finish eating after someone;
Temper the body;
Be more often in the fresh air;
Do sport;
Take multivitamins that prevent you from getting sick in the autumn-spring period;
Pay due attention to proper nutrition.

Today, there is no specific treatment for chronic mononucleosis in adults, and all therapy comes down to eliminating unpleasant symptoms, strengthening the whole body, as well as taking immunocorrectors and agents that prevent intoxication of the patient's body.

There are a huge number of diseases in the world. Both bacteria and viruses can provoke their development. For successful treatment, it is important not only to know the causative agent of the disease, but also in what ways you can deal with it. We will introduce you to one of these diseases further and analyze what infectious mononucleosis is (symptoms, treatment) and how it develops in adults and children.

What is infectious mononucleosis

A disease with this name has been known since 1885, when it was described by N. F. Filatov. The second name for this disease is idiopathic lymphadenitis, and it is caused by the Epstein-Barr virus.

By the way, the named virus can be attributed to the family of herpes viruses, but it has one distinctive feature - in the process of its development it does not lead to the death of the host cell, but, on the contrary, stimulates its growth.

After the virus enters the human body, it begins to affect the epithelial tissue in the oral cavity and nasopharynx. It is quite difficult to defeat it, and it remains in the body for almost a lifetime. And during periods of weakened immunity, the virus, unfortunately, will make itself felt.

Causes of the development of the disease in adults

Before considering infectious - the symptoms of this disease - it is necessary to find out how infection can occur. As a rule, its source is a sick person or a carrier of the virus.

The latter enters the body through the air or personal hygiene items and dishes, on which droplets of saliva remain. In saliva, the virus is able to persist throughout almost the entire duration of the disease - during the incubation period, during the height of the disease, and even after recovery.

There is a version that infection can occur during intercourse, but it has not been proven to date.

Interestingly, most often the mononucleosis virus affects young people and children, and after 40 years this disease is very rare.

Causes of the development of the disease in children

Unfortunately, the most common target for the virus is children under 10 years of age. A child at this age is usually in a children's team, whether it be a kindergarten or a school, which means that he has the opportunity to catch the infection by airborne droplets.

The virus is not particularly resistant, so it dies quickly enough in the external environment. Infection can occur only through close contact, therefore, it cannot be classified as overly contagious.

The Epstein-Barr virus feels best in the salivary glands, so it is transmitted most often:

when sneezing or coughing;
with a kiss;
if you use one utensil, toothbrushes or toys that children often drag into their mouths.

By the way, infection is also possible during a blood transfusion if it is infected with a virus.

Since the infection is transmitted through the air with droplets of saliva, the risk of infection increases during an outbreak of colds, when everyone around is coughing and sneezing.

Symptoms of infectious mononucleosis in a child will not appear immediately, since the disease has its own incubation period. It lasts from 5 to 15 days, in some cases it can last up to a month or a little more.

The manifestation of the disease in adults

Infectious mononucleosis in adults begins to show its symptoms after the virus from the nasal cavity or gastrointestinal tract enters the bloodstream and invades lymphocytes, where it becomes practically a permanent resident. With the onset of favorable conditions for him, the disease will not make you wait long for its manifestation.

The most characteristic symptoms of infectious mononucleosis are:

general weakness;
muscle pain;
headache;
possible nausea;
chills;
decrease in appetite.

A few days (and sometimes weeks) after the first signs appear, the patient has the most basic symptoms of mononucleosis:

Temperature rise. In almost 85-90% of cases, its indicators are quite high, only in some they do not exceed 38 degrees. During fever, as a rule, there is no severe chills or sweating.
Enlarged lymph nodes. First of all, the nodes on the neck are involved, and then those located in the armpits and in the groin. Lymph nodes can range in size from a pea to a walnut, with pressure, pain is felt, under the skin they move freely relative to the tissues.
Sore throat and heavy plaque on the tonsils.

In addition to those listed, the most characteristic symptoms of infectious mononucleosis are other signs that may appear at the same time, or may replace each other:

During the development of the disease, the virus causes an enlargement of the liver and spleen. These organs reach their maximum size at 6-10 days. This process may be accompanied by yellowness of the skin or sclera of the eyes. The danger of this period lies in the fact that even minor injuries can lead to rupture of the organ, especially the spleen.
In addition, a rash appears on the skin (although this is not the main symptom of infectious mononucleosis). It may resemble the mentioned symptom may appear at any period of the disease and just as suddenly disappear.

Now you know the symptoms that accompany infectious mononucleosis.

A blood test, the indicators of which must be taken into account, as a rule, demonstrates the appearance in the blood of special leukocytes, which are called atypical mononuclear cells. Their content in the blood reaches 10%.

The whole disease usually proceeds for two weeks, but sometimes it can drag on for a couple of months. After that, either recovery occurs, or complications begin to appear. Throughout the treatment, with the diagnosis of infectious mononucleosis, symptoms, blood tests, indicators of the norm of the general condition of the patient's body should be monitored by a specialist.

The manifestation of the disease in children

At present, catching any viral disease is easier than ever if you are constantly surrounded by people. If the baby has been in contact with a patient with mononucleosis, then in the next 2-3 months the disease may manifest itself. Symptoms may not appear if his immune system is strong enough.

If the parents notice that the temperature has appeared, the child is lethargic and constantly wants to sit or lie down, then you should consult a doctor. According to Komarovsky, describing infectious mononucleosis (symptoms in children), it can manifest itself in different ways, but the lymph nodes are bound to increase. Therefore, the baby first of all needs to feel them on the neck and in the groin.

Quite often, infectious mononucleosis begins with general catarrhal phenomena, which parents attribute to the common cold. But gradually the child's condition worsens:

body temperature rises;
stuffy nose;
there is soreness and sore throat.

By the way, with the diagnosis of infectious mononucleosis, the symptoms (you can see a photo of their manifestations in the article) most often affect the increase in tonsils and their redness.

In some babies, the disease develops rapidly. This manifests itself:

prolonged high temperature;
chills;
general weakness;
drowsiness;
increased sweating.

A symptom of infectious mononucleosis, which can be called the culmination of the disease, is graininess on the back of the pharynx, called follicular hyperplasia.

In addition, in children, as in adults, internal organs increase - the spleen and liver. And so much so that, for example, the spleen can not stand it, and it ruptures. Lymph nodes also enlarge and a rash appears on the body. Most often, it is quite strong and can be localized not only on the arms and legs, but also on the back, stomach, face. Usually, rashes do not cause concern, are not accompanied by itching, so no measures to combat them should be taken. If the rash begins to itch after taking antibiotics, then this means an allergic reaction to the medicine.

Almost all infectious disease specialists believe that an important symptom of infectious mononucleosis is polyadenitis, which develops as a result of hyperplasia of the lymphoid tissue. On the tonsils, the palate forms a coating of gray or whitish-yellow color, which has a loose texture.

Parents need to pay special attention to the lymph nodes. The cervical ones increase most strongly - this can be seen clearly when the child turns his head. If there is an increase in the lymph nodes in the abdominal cavity, then this can lead to severe pain, which can provoke an incorrect diagnosis, which is fraught with unnecessary surgical intervention.

As a rule, infectious diseases practically do not show up to a year, because such babies usually do not get this disease, as they receive ready-made antibodies from their mother.

Diagnosis in adults

It is not always possible to recognize the disease by its clinical manifestations, especially if it occurs in a mild form. The most reliable way to recognize infectious mononucleosis is a blood test that will detect atypical mononuclear cells.

In order to check the symptoms that are present at the diagnosis of "infectious mononucleosis", a blood test is done differently, for example:

Conduct a serological test for antibodies to the Epstein-Barr virus. If the disease is present, then an increased level of class M immunoglobulins is noted.
In the laboratory, the antigens of the virus are determined in the blood.
A PCR study of the patient's blood is carried out, and scrapings from the oral mucosa are analyzed. If mononucleosis develops, then virus DNA is necessarily detected.

In addition to a blood test, an ultrasound examination of the internal organs is performed, but it shows more the severity of the disease.

Diagnosis of the disease in children

To recognize mononucleosis and distinguish it from a cold, a specialist prescribes a series of tests to a child:

conduct a blood test for the presence of antibodies IgM, IgG to the Epstein-Barr virus;
do a general and biochemical blood test;
perform ultrasound of the internal organs.

It is quite difficult to make an accurate diagnosis for a child, because there is a risk of confusing the disease, especially at the initial stage, with a common sore throat. Hematological changes are an important symptom of infectious mononucleosis, so a serological study must be carried out.

A blood test in a child, if there is mononucleosis, will show:

Increased ESR.
Increase in the content of atypical mononuclear cells up to 10%. But it is worth considering that these cells do not appear in the blood at the very beginning of the development of the disease, but only after a couple of weeks.

Children may have other ailments that have similar symptoms to mononucleosis, so it is very important for a doctor to distinguish this disease from a sore throat, to exclude Botkin's disease, acute leukemia, diphtheria, and some others. In the arsenal of physicians, there are many new diagnostic methods and methods that allow you to quickly recognize the disease, for example, PCR.

If infection with infectious mononucleosis occurs, then for several months they are repeated to determine HIV infection, since it can also provoke the appearance of mononuclear cells.

Therapy for mononucleosis

Adults are much less likely to get this disease than children, but if the infection has occurred and the diagnosis has been confirmed, then therapy can be carried out at home. Whether or not bed rest is needed at the same time depends on the severity of intoxication of the body. If the disease is accompanied by the manifestation of hepatitis, then a special diet is recommended.

Specific treatment for infectious mononucleosis has not been developed, the following types of therapy are usually carried out:

Carry out detoxification of the body.
desensitizing treatment.
Restorative therapy.
Managing symptoms of the disease, which may include gargling, taking antibiotics if the situation requires it.
If the throat is very swollen and there is a risk of developing asphyxia, then Prednisolone is prescribed for several days.

If there are no complications, then after two weeks the disease recedes and recovery occurs.

Treatment of mononucleosis in children

Currently, physicians do not have a single plan for the treatment of this disease in children. There is no such antiviral drug that could quickly deal with the Epstein-Barr virus. Most often, therapy is carried out at home, hospitalization is recommended for the following symptoms:

the temperature for a long time is kept at a mark of more than 39 degrees;
there are pronounced signs of intoxication of the body;
there is a development of complications of the disease;
there is a risk of asphyxia.

Infectious mononucleosis in children, the symptoms and treatment are almost the same as in adults, but there are some subtleties:

The treatment is aimed at reducing the symptoms of the manifestation of the disease.
Antipyretics are used at high temperatures, for example, Ibuprofen, Paracetamol.
And to eliminate the symptoms of angina, antiseptic drugs, such as Imudon, Irs 19, are effective.

General strengthening therapy is carried out, special attention is paid to the intake of vitamins of groups B, C and P. If an ultrasound scan shows an enlarged liver, then a special diet is required, as well as taking choleretic drugs and hepatoprotectors.

A good effect in the treatment gives the combined use of immunomodulators and antiviral drugs.

Taking antibiotics is justified if a secondary bacterial infection joins and complications begin, but penicillin preparations are usually not prescribed, since in a large number of cases they provoke the development of allergic reactions.

To help the intestines, along with antibiotics, it is necessary to take probiotics, for example, Acipol, Narine.

In severe cases, with severe laryngeal edema, a transfer to artificial lung ventilation is indicated.

Possible complications of the disease

If the therapy is prescribed incorrectly, or the recommendations of doctors are not followed, then infectious mononucleosis can give serious complications:

On the part of the nervous system, it can be meningitis, encephalitis, spinal cord injury, the development of Guillain-Barré syndrome, hallucinations, increased nervous excitement can be observed.
A blood test can show a decrease in platelets, a decrease in the number of white blood cells, as well as autoimmune anemia.
There have been cases of retinal hemorrhage.
Spontaneous rupture of the spleen, if there is an excessive increase in it.
Hepatitis.
Due to severe swelling of the tonsils, respiratory failure may develop.
The inflammatory process can affect the kidneys.
The defeat of the glandular tissue leads to parotitis, pancreatitis and problems with the thyroid gland.
Due to the fact that the virus strongly suppresses the immune system, purulent infections are possible.

The famous doctor Komarovsky recommends that all parents, if a child falls ill with infectious mononucleosis, do not panic, but endure the peak of the disease and follow all the doctor's recommendations. When taking many medicines, it is necessary to carefully monitor their tolerance by the baby's body, so as not to aggravate the appearance of complications even against this background.

How to recover faster after an illness

The longest recovery takes place in the children's body. At a high temperature, you should not force the baby to eat, let him drink more compotes and fruit drinks, as well as tea with lemon. After the disease begins to recede, the appetite for the child will return. But after recovery for about 6 months, you will need to follow a diet so that the liver recovers.

Children who have had this disease, at first, quickly get tired, feel weak, so you should not overload them with physical and mental work.

It is desirable that the recovery process be monitored by a doctor who at any time could give valuable recommendations and advice. Hepatologist consultations may be required, and biochemical and serological blood tests should also be performed periodically.

To prevent the development of complications after recovery, children are recommended:

undergo a medical examination;
in physical education classes to engage in a special group;
you can not go on hiking trips, especially over long distances;
it is forbidden to participate in sports competitions;
it is desirable to prevent overheating or hypothermia of the body;
Vaccinations are prohibited until full recovery.

After illness, walks in the fresh air, proper and healthy nutrition and more rest are useful.

There is still no vaccine against infectious mononucleosis, it is only at the development stage, so prevention is important, which consists in observing the rules of personal hygiene. It is necessary to explain to the child that you should not communicate closely with sick children and adults. The described disease, as a rule, is not massive, but manifests itself in isolated cases, therefore, observing all precautions, you can be almost sure that the mononucleosis virus will not overtake you.

Infectious diseases, of which there are more than two hundred, have a variety of names. Some of them have been known for many centuries, some appeared in the era of modern times after the development of medicine, and reflect some of the features of clinical manifestations.

For example, it is so named for the pink color of the skin rash, and typhus is so named because the patient's state of consciousness is disturbed by the type of toxic "prostration", and resembles fog, or smoke (translated from Greek).

But mononucleosis stands "apart": perhaps this is the only case when the name of the disease reflects a laboratory syndrome that is "not visible to the naked eye." What is this disease? How does it affect blood cells, flow and be treated?

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Infectious mononucleosis - what is it?

the onset of the disease may be similar to a cold

First of all, this disease has several other names. If you hear such terms as "glandular fever", "Filatov's disease", or "monocytic tonsillitis" - then know that we are talking about mononucleosis.

If you decipher the name "mononucleosis", then this term means an increase in the content of mononuclear, or mononuclear cells in the blood. These cells include special types of leukocytes, or white blood cells, which perform a protective function. These are monocytes and lymphocytes. Their content in the blood is not just increased in mononucleosis: they become altered, or atypical - this is easy to detect when examining a stained blood smear under a microscope.

Infectious mononucleosis is a viral disease. Since it is caused by a virus, not a bacterium, it must be said right away that the use of any antibiotics is completely pointless. But this is often done, as the disease is often confused with a sore throat.

After all, the mechanism of transmission in mononucleosis is aerosol, that is, airborne, and the disease itself occurs with damage to the lymphoid tissue: pharyngitis and tonsillitis (tonsillitis) occur, hepatosplenomegaly appears, or an increase in the liver and spleen, and the content of lymphocytes and monocytes increases in the blood, which become atypical.

Who is guilty?

Causes infectious mononucleosis, which belongs to the herpes viruses. In total, there are almost a dozen families of herpes viruses and even more of their species, but only lymphocytes are so sensitive to this type of virus, since they have receptors for the envelope protein of this virus on their membrane.

The virus is unstable in the external environment, and quickly dies with any available methods of disinfection, including ultraviolet irradiation.

A characteristic feature of this virus is a special effect on cells. If the usual viruses of the same herpes and chickenpox show a pronounced cytopathic effect (that is, leading to cell death), then EBV (Epstein-Barr virus) does not kill cells, but causes their proliferation, that is, active growth. It is this fact that lies in the development of the clinical picture of mononucleosis.

Epidemiology and routes of infection

Since only people suffer from infectious mononucleosis, a sick person can infect a healthy person, and not only a bright, but also an erased form of the disease, as well as an asymptomatic carrier of the virus. It is due to healthy carriers that the "viral cycle" in nature is maintained.

In most cases, the infection is transmitted by airborne droplets: when talking, screaming, crying, sneezing and coughing. But there are other ways in which infected saliva and body fluids can enter the body:

kisses, sexual way;
through toys, especially those that have been in the mouth of a child with a virus carrier;
through a transfusion of donor blood, if the donors are carriers of the virus.

Susceptibility to infectious mononucleosis is universal. It may seem incredible, but most healthy people are infected with this virus and are carriers. In underdeveloped countries, where there is a large crowding of the population, this occurs in babies, and in developed countries - in adolescence and youth.

Upon reaching the age of 30 - 40, the majority of the population is infected. It is known that men are more likely to suffer from infectious mononucleosis, and people over 40 years old get sick very rarely: infectious mononucleosis is a disease of a young age. True, there is one exception: if a patient is sick with HIV infection, then at any age he can not only develop mononucleosis, but also recur. How does this disease develop?

Pathogenesis

Infectious mononucleosis in adults and children begins with the fact that infected saliva enters the oropharynx, and there the virus replicates, that is, its primary reproduction occurs. It is the lymphocytes that are the object of the attack of the virus, and quickly "infect". After that, they begin to transform into plasma cells, and synthesize various and unnecessary antibodies, such as hemagglutinins, which can stick together foreign blood cells.

A complex cascade of activation and suppression of various parts of the immune system is launched, and this leads to the accumulation of young and immature B-lymphocytes in the blood, which are called "atypical mononuclear cells". Despite the fact that these are their own cells, albeit immature, the body begins to destroy them, since they contain viruses.

As a result, the body weakens, trying to destroy a large number of its own cells, and this contributes to the attachment of microbial and bacterial infection, since the body and its immunity are "busy with other things."

All this is manifested by a generalized process in the lymphoid tissue. The proliferation of immunity cells causes hypertrophy of all regional lymph nodes, the spleen and liver increase, and in the case of a severe course of the disease, necrosis in the lymphoid tissue is possible, and the appearance of various infiltrates in organs and tissues.

Symptoms of infectious mononucleosis in children and adults

High temperature up to 40 - a symptom of mononucleosis (photo 2)

Infectious mononucleosis has a "vague" incubation period that can last from 5 to 60 days, depending on age, immune status, and the amount of viruses that have entered the body. The clinical picture of symptoms in children and adults is approximately the same, only in children an enlargement of the liver and spleen manifests early, which in adults, especially with erased forms, may not be determined at all.

As with most diseases, infectious mononucleosis has a period of onset, peak and recovery, or convalescence.

Initial period

The disease has an acute onset. Almost on the same day, the temperature rises, chills occur, then a sore throat and regional lymph nodes increase. If the onset is subacute, then lymphadenopathy occurs first, and only then fever and catarrhal syndrome join.

Usually the initial period lasts no more than a week, and people often think that this is the “flu” or other “cold”, but then the peak of the disease sets in.

Clinic of the height of the disease

The classic signs of "apotheosis of mononucleosis" are:

High fever up to 40 degrees, and even higher, which can stay at this level for several days, and with lower numbers - up to a month.
A kind of "mononucleosis" intoxication, which is not like the usual, viral intoxication. Patients get tired, stand and sit with difficulty, but usually maintain a mobile lifestyle. They have no desire, as in ordinary infections, to go to bed even with a high temperature.
polyadenopathic syndrome.

The lymph nodes close to the "entrance gate" are enlarged. More often than others, the nodes of the lateral surface of the neck are affected, which remain mobile, painful, but enlarged, sometimes up to the size of a chicken egg. In some cases, the neck becomes "bullish", and mobility is limited when rotating the head. The defeat of the inguinal, axillary nodes is somewhat less pronounced.

This symptom of infectious mononucleosis persists for a long time, and disappears slowly: sometimes 3-5 months after recovery.

Enlargement and severe swelling of the palatine tonsils, with the appearance of loose deposits, or tonsillitis. They even close together, making it difficult to breathe. The patient's mouth is open, nasality, swelling of the posterior pharyngeal wall (pharyngitis) occurs.
The spleen and liver are almost always enlarged. This symptom of infectious mononucleosis in children is noted quite often, and is well expressed. Sometimes there are pains in the side and right hypochondrium, slight jaundice and increased activity of enzymes: ALT, AST. This is nothing but benign hepatitis, which soon passes.
Picture of peripheral blood. Of course, the patient does not complain about this, but the exceptional originality of the test results requires that this symptom be indicated as the main symptom: against the background of moderate or high leukocytosis (15-30), the number of lymphocytes and monocytes increases to 90%, of which almost half are atypical mononuclear cells. This sign gradually disappears, and after a month the blood "calms down".
Approximately 25% of patients have a different rash: tubercles, dots, spots, small hemorrhages. The rash does not bother, appears towards the end of the period of initial appearances, and after 3-6 days disappears without a trace.

About diagnosing mononucleosis

Infectious mononucleosis is a disease with a characteristic clinical picture, and it is always possible to identify atypical mononuclear cells in peripheral blood. It is pathognomonic, as are fever, swollen lymph nodes, hepatosplenomegaly, and tonsillitis combined.

Additional research methods are:

Hoff-Bauer reaction (positive in 90% of patients). Based on the detection of hemagglutinating antibodies, with an increase in their titer by 4 or more times;
ELISA methods. Allow to determine marker antibodies that confirm the presence of virus antigens (to capsid and nuclear antigens);
PCR for the detection of the virus in blood and saliva. It is often used in newborns, since it is difficult for them to focus on the immune response, since immunity has not yet been formed.

Treatment of infectious mononucleosis, drugs

Uncomplicated and mild forms of infectious mononucleosis are treated at home by both children and adults. Patients are hospitalized with jaundice, a significant increase in the liver and spleen, an unclear diagnosis. The principles of treatment for infectious mononucleosis are:

The diet requires giving up spicy, smoked, fatty and fried foods in order to facilitate the work of the liver;
Semi-bed rest, plentiful, vitamin drink are shown;
It is necessary to rinse the oropharynx with antiseptic solutions ("Miramistin", "Chlorhexidine", "Chlorophyllipt"), in order to avoid the addition of a secondary infection;
Showing antipyretics from the group of NSAIDs.

Attention! How to treat infectious mononucleosis in children, and what drugs should not be used? All parents should remember that taking aspirin in any form and dose is strictly prohibited in children until they reach the age of at least 12-13 years, since a serious complication, Reye's syndrome, may develop. Only paracetamol and ibuprofen are used as antipyretic drugs.

Antiviral therapy: interferons and their inducers. "Neovir", Acyclovir. They are used, although their effectiveness has been proven in the study only in the laboratory;
Antibiotics are prescribed when suppuration appears on the tonsils, other purulent-necrotic complications. Fluoroquinolones are used more often than others, but ampicillin can contribute to the appearance of a rash in most patients;
If a rupture is suspected, the patient should be urgently operated on, according to vital indications. And the attending physician should always pay attention to patients who are being treated at home, that with an increase in jaundice, the appearance of acute pain in the left side, severe weakness, and a decrease in pressure, it is urgent to call an ambulance and hospitalize the patient in a surgical hospital.

How long to treat infectious mononucleosis? It is known that in 80% of cases a significant improvement occurs between 2 and 3 weeks of illness, so active treatment should be carried out for at least 14 days from the moment of the first signs of the disease.

But, even after improving the state of health, it is necessary to limit the motor mode and sports for 1 - 2 months after discharge. This is necessary because the spleen is enlarged for a long time, and there is a significant risk of its rupture.

In the event that severe jaundice has been diagnosed, then the diet must be followed for 6 months after recovery.

Consequences of mononucleosis

After infectious mononucleosis remains strong immunity. There are no recurrences of the disease. In rare exceptions, mononucleosis can be fatal, but it can be caused by complications that have little to do with the development of the virus in the body: it can be obstruction and swelling of the airways, bleeding due to rupture of the liver or spleen, or the development of encephalitis.

In conclusion, it must be said that EBV is not at all as simple as it seems: remaining to persist in the body for life, it often tries to “show its abilities” in cell proliferation in other ways. It causes Burkitt's lymphoma and is thought to be a possible cause of some carcinomas because it has been shown to be oncogenic, or the ability to "tend" the body into cancer.

Also, its role in the rapid course of HIV infection is not excluded. Of particular concern is the fact that the hereditary material of EBV is firmly integrated into the affected cells with the human genome.