Mononucleosis in adults consequences

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Infectious mononucleosis in adults, symptoms, treatment, causes

Infectious mononucleosis (Filatov's disease) is an acute infectious disease characterized by fever, tonsillitis, lymphadenopathy, enlargement of the liver and spleen, as well as a mononuclear blood reaction.

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Infectious mononucleosis is characterized by changes in leukocytes in the blood and the development of reactive lymphadenitis with enlargement of the lymph nodes and spleen.

This disease is caused by several viruses, including herpes viruses. The source of infection is a sick person; infection occurs through airborne droplets or household contact (with saliva during a kiss, through tableware) routes. There have been cases of transmission of this infection through blood transfusions. In general, the peak incidence of infectious mononucleosis occurs during the cold period of the year. According to statistics, children and young people are more likely to suffer from it; This disease often occurs in children's and youth groups, becoming a group disease.

Infectious mononucleosis has many other names - glandular fever, Filatov's disease, Pfeiffer's disease, monocytic tonsillitis.

Like all infectious diseases, infectious mononucleosis begins with an incubation period, which usually lasts 4-12 days, but sometimes extends to 40 days.

According to the clinical course, the following forms of infectious mononucleosis are distinguished: typical, atypical (erased, asymptomatic).

The disease occurs in all countries in the form of sporadic cases or small outbreaks (usually in spring and autumn). Adolescents and young adults are most often affected. Transmission is carried out by airborne droplets.

Causes of mononucleosis in adults

Etiology, pathogenesis. The causative agent is considered to be a virus, but its properties have not been studied enough. It has the ability to selectively affect the reticuloendothelial system, especially the lymph nodes, which results in their hyperplasia. Irritation and increased mitotic activity of lymphoreticular tissue are observed. A large number of atypical mononuclear cells enter the peripheral blood. Infiltration of mononuclear cells can be observed in the liver, as well as in the spleen and other organs. The layering of secondary bacterial flora is important.

Symptoms, course of infectious mononucleosis

As a rule, body temperature rises to 38.5-39.5 ° C; This is followed by a sore throat when swallowing. In the patient’s throat you can see reddened, hyperemic and loosened tonsils covered with a gray coating; Enlarged anterior and posterior cervical lymph nodes can be found on the neck. Thus, the signs of infectious mononucleosis resemble a sore throat. Upon closer examination of the patient, an increase in the inguinal and axillary lymph nodes can be observed. In addition, this disease is characterized by an enlarged liver and spleen, as well as changes in the picture of peripheral blood - leukocytosis (increased number of white blood cells). The patient complains of malaise, headache, sore throat when swallowing, as well as pain in muscles and joints.

Incubation lasts about a week (4 to 13 days). The disease often begins acutely. Fever and symptoms of intoxication quickly increase and reach their maximum severity within 2-4 days. Patients complain of headache, weakness, weakness, pain when swallowing, pain in muscles and joints. The temperature reaches 38-40°. The temperature curve is of an irregular type, sometimes wavy (two-wave), the duration of fever is 1-3 weeks. Some patients experience prolonged low-grade fever with moderate symptoms of intoxication.

Tonsillitis in infectious mononucleosis can be catarrhal, follicular, ulcerative-necrotic, pseudomembranous, sometimes resembling changes in the pharynx in diphtheria. Sometimes tonsillitis appears only on the 4-7th day from the onset of the disease. Enlargement and tenderness of the lymph nodes are constant signs (in 90-95% of patients). The maxillary and posterior cervical lymph nodes are constantly affected, and less commonly the axillary, elbow, inguinal and femoral lymph nodes. Great difficulties sometimes arise when the mesenteric lymph nodes are affected. In 25% of patients, exanthema is observed (maculopapular, roseola, rubella-like, less often scarlet-like). Enlargement of the liver and spleen is observed in almost all patients (usually from the 3-5th day of illness) and lasts 3-4 weeks. Liver damage is especially pronounced in the so-called icteric forms of infectious mononucleosis. Changes in peripheral blood are manifested by moderate leukocytosis (9000 in 1 mm 3) and mononuclear blood reaction. The number of mononuclear elements (lymphocytes, monocytes, atypical mononuclear cells) reaches 70-85%. Mononuclear reaction can last 3-6 months.

Recognizing mononucleosis in adults

Recognition is based on characteristic clinical data (fever with symptoms of intoxication, lymphadenopathy, changes in the pharynx, enlargement of the liver and spleen, mononuclear blood reaction). For serological confirmation of the diagnosis, the sheep erythrocyte agglutination reaction (Paul-Bunnell reaction) is used, the diagnostic titer of which is considered to be 1:32 or higher. However, this reaction is not specific. Of greater importance is the formulation of the Hangenutiu-Deicher-Paul-Bunnel-Davidson (HD/PBD) reaction. It is considered positive when adsorption of anti-sheep antibodies is observed with an extract from bovine red blood cells and there is no adsorption when using a guinea pig kidney extract.

Treatment of infectious mononucleosis in adults

First of all, the patient is prescribed bed rest, plenty of fluids, vitamins, antipyretic and antibacterial drugs. Antibiotics are used

penicillin groups (cefazolin, cephalexin); antiseptics, for example iodinol - a long-acting iodine preparation. In this case, it is used to wash the tonsils (4-5 washes in 2-3 days). Caution should be exercised as a side effect of this drug is iodism. Furacilin, which has antimicrobial activity against a number of pathogenic bacteria, can be used as an antiseptic and antibacterial agent for rinsing the oropharynx. It is mainly used for purulent-inflammatory processes. The pharmacy chain may offer you a solution of furatsilin ready for gargling. A contraindication to its use is hypersensitivity to nitrofuran derivatives.

A complex of vitamins and symptomatic medications are prescribed. If there are pronounced changes in the pharynx, antibiotics (penicillin, tetracyclines) can be used to suppress the layered microbial infection. In severe forms (high fever, toxicosis, significant changes in the pharynx, jaundice), steroid hormones (cortisone, prednisone, prednisolone) can be recommended in medium doses (prednisolone 20-25 mg per day) for 5-10 days.

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Signs and symptoms of chronic mononucleosis in adults

Mononucleosis or glandular fever, monocytic tonsillitis, Pfeiffer disease, etc. is a disease caused by the Epstein-Barr virus. Clinical characteristics include fever, generalized lymphadenopathy, tonsillitis, enlarged liver and spleen, and characteristic changes in the blood count. In some cases, the disease can take a chronic form.

Epstein-Barr virus is a human B-lymphotropic virus that belongs to the group of herpes viruses. It can hide for a long time in the cells of an infected person in the form of a dormant infection, so the source of infection is a sick person or a carrier of the virus. Mostly people under 40 years of age get sick; after suffering from the disease, everyone develops a strong immunity to mononucleosis.

The virus is released into the environment starting from the last days of the incubation period. Duration – 6-18 months. The transmission mechanism of the Epstein-Barr virus is airborne, through a kiss, dirty hands, dishes, and hygiene items. During blood transfusion and during childbirth from an infected mother.

There is a high degree of susceptibility to infection, but when infected, both mild and erased clinical forms can develop. The spread of infection occurs everywhere, there are no epidemic outbreaks, and there is an increased incidence in girls and boys. In case of infection with the virus at an older age, the disease does not have pronounced symptoms.

Since most adults usually have specific immunity already formed, the clinical course of the disease is rare. When air containing the virus is inhaled, epithelial cells of the upper respiratory tract and pharynx are damaged in humans. Moderate inflammation of the mucous membrane develops; with the flow of lymph, the infection enters nearby lymph nodes, which contributes to the appearance of lymphadenitis.

In the blood, the virus hijacks B-lymphocytes and begins to actively spread. As a result, specific reactions are formed and pathological cell damage occurs. The pathogen is transported through the blood vessels throughout the body, reaching important organs. The Epstein-Barr virus lives in the human body throughout life; if immunity decreases, it manifests its negative impact.

Sometimes weakness, malaise, catarrhal symptoms may be observed, and if measures are not taken and an accurate diagnosis is not established, in such cases there is a gradual increase in symptoms. Weakness increases, the temperature rises, nasal congestion, difficulty breathing, sore throat and sore throat appear. In the acute period, increased sweating and intoxication are observed.

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Patients complain of muscle aches, headaches, and pain when swallowing. Fever torments the patient for several days, and even a month; the course may vary. After a week, the disease should go into an exacerbation phase. General intoxication, sore throat, swelling of the lymph nodes, enlargement of the liver and spleen appear.

The patient's condition may worsen significantly. You can find catarrhal, ulcerative-necrotic processes, membranous or follicular sore throat with intense redness of the mucous membrane of the tonsils, yellowish and loose plaque in the throat. Examination reveals granularity of the posterior pharyngeal wall and mucosal hemorrhages.

From the first days of the disease, multiple lesions of the glands (polyadenopathy) occur. Enlarged lymph nodes are easily detected in almost any area accessible for examination by palpation. The occipital and submandibular nodes are most often affected. During palpation, the density of the lymph nodes is determined; usually they are dense, mobile, painless or with mild pain.

There is swelling of the surrounding tissue, yellowness of the sclera and skin, dark urine is released and dyspepsia appears. Spots, papules and various rashes are common, the location of which varies. The rash goes away quickly, there is no itching or burning of the skin. The acute period lasts about 2-3 weeks. Then comes the time for the gradual subsidence of clinical symptoms and the process of restoring normal functioning of the body begins.

Body temperature normalizes, signs of sore throat disappear, the liver and spleen acquire their natural size. It happens that for several weeks there are signs of adenopathy and low-grade fever. In a chronic relapsing course, the period of illness is prolonged.

Consequences of mononucleosis in adults

Complications from mononucleosis may be absent or very severe, sometimes the disease ends in death. One of the causes of death is splenic rupture. There are known cases of severe hepatitis, tachycardia, psychosis, and kidney inflammation.

Paralysis of facial muscles and cranial nerves occurs.

Sometimes you have to simultaneously treat pneumonia and fight swelling of the eyelids. Possible narrowing of the lumen of the larynx (airway obstruction), requiring emergency surgical intervention. Treatment should be carried out in a timely manner; if you seek help from a doctor at the first signs of the disease, the consequences of mononucleosis can be avoided.

Infectious mononucleosis (mononary tonsillitis or glandular fever) is a disease caused by the filtering Epstein-Barr virus (human B-lymphotropic virus), belonging to the group of herpes viruses. It can be present in human cells for a long time as a latent infection. Most often, children are susceptible to the disease; outbreaks of the disease occur all the time.

Mononucleosis is not a pleasant disease; it mainly affects children; in adults it occurs more as an anomalous phenomenon. Feverish manifestations can be relieved with steamed chamomile, mint, dill seeds, rose tea, and rosehip decoction. In addition, you should drink tea from the leaves of raspberries, currants, sea buckthorn, maple, and viburnum.

At the first stage, mononucleosis is an acute infectious disease caused by infection with the Epstein-Barr virus from the herpes group. The virus affects the enlargement of lymph nodes, but the lymph nodes of the neck are most affected. There is an increase in the important organs of the spleen and liver, and inflammatory processes occur in the heart muscle.

The infectious mononucleosis virus is a common occurrence these days, especially in childhood. The disease usually occurs in mild forms and is therefore very difficult to diagnose. The main feature of the virus is damage to lymphoid tissue. Which is found in the lymph nodes, tonsils, liver, spleen. It is these organs that are most susceptible to mononucleosis.

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Symptoms and treatment of infectious mononucleosis in adults

Mononucleosis most often affects children and adolescents, and many people have a question: can infectious mononucleosis occur in adults? Yes, it's quite possible. Although most people develop a strong immunity to this disease by the age of forty, cases of mononucleosis still occur. The likelihood of getting sick decreases sharply after forty years.

Infectious mononucleosis is a disease of a viral nature. Sometimes it is also called monocytic tonsillitis or glandular fever. The disease is caused by the very common Epstein-Barr virus.

What is Epstein-Barr virus and how is it transmitted?

This virus belongs to the group of human herpes viruses.

It can lie dormant in the human body for a long time without showing any symptoms. In this case, the person is considered a carrier of the virus and at the same time poses a danger as a source of infection. The virus begins to be released especially actively at the end of the incubation period (which on average lasts from 30 to 50 days). The main route of transmission of infection is airborne droplets. Infection is possible through common household items, poor hand washing, and failure to comply with other hygiene rules. The disease can also be transmitted through blood transfusion, as well as after childbirth from a sick mother to her child.

In other words, the disease is highly contagious. But, since specific immunity to the virus develops with age, symptoms in adults can be somewhat smoothed out, and the disease is easier.

Course of the disease

A person inhales air containing the virus, and the epithelial layer of the respiratory tract and pharynx is affected. The mucous membranes become inflamed, and through the lymph the virus enters neighboring lymph nodes, causing them to become significantly enlarged (lymphadenopathy). Swollen lymph nodes are a very characteristic sign of this disease, which immediately gives reason to suspect mononucleosis.

Penetrating into the blood, the virus continues to actively multiply and spread throughout the body, capturing lymphocytes. It can penetrate through the blood vessels into various organs, disrupting the normal functioning of cells. The virus remains in the body until the end of life and during periods of severe weakening of immunity it can manifest its negative effects.

Main symptoms of the disease

At first, you may experience slight weakness and malaise. If the disease is left unattended, its symptoms worsen. Weakness increases, temperature rises. Fever can last more than one week, and in some cases even a month. The nose is often stuffy, breathing is difficult, the throat is sore and sore. In acute cases, intoxication symptoms increase and excessive sweating appears.

Many patients complain of aching sensations in their bones and muscles. In addition to enlarged lymph nodes, enlargement of other organs (liver, spleen) is sometimes observed. Enlarged lymph nodes are easily detected by palpation. They are very dense to the touch, yet quite mobile, there is no pain in them. The nodes most often affected are the submandibular and occipital nodes.

If the patient's condition seriously worsens, signs of a sore throat become noticeable, the tonsils become very red, and a yellowish coating is detected. Hemorrhages occur on the mucous membranes, and granularity is observed on the back wall of the pharynx. Yellowness of the skin and sclera is often observed, and the urine is dark in color. All kinds of rashes are sometimes observed on the skin, and their localization can be very different. But such a rash disappears quite quickly (after just a few days), without bothering patients with excessive burning or itching.

Usually after two or three weeks the disease begins to recede, and the sick person gradually returns to his normal life. The temperature drops to normal, the spleen and liver return to their natural size.

What can be the consequences of mononucleosis in adults?

In most cases, the prognosis in adults is favorable, the disease recedes and patients return to a normal lifestyle. But in some patients, mononucleosis takes a chronic form, and then the process is delayed. Moreover, in some cases the consequences of the disease can be very serious and sometimes even lead to the death of the patient.

What could happen? The main cause of death from mononucleosis is splenic rupture. There is a possibility of complications in the form of severe hepatitis and possible kidney inflammation. There is a risk of developing pneumonia, which must be treated immediately.

Serious hematological disorders are also possible: excessive destruction of red blood cells (a type of anemia), a decrease in the content of granulocytes and platelets in the blood.

The virus that causes mononucleosis can also affect the nervous system. Therefore, there is a small chance of some neurological complications. This may be damage to the cranial and facial nerves, resulting in paralysis of the facial muscles. Sometimes polyneuritis (multiple nerve damage), encephalitis is possible, and there is even a possibility of developing psychosis.

If you consult a doctor in time and start treatment, all the unpleasant consequences of mononucleosis can usually be completely avoided.

How is mononucleosis diagnosed?

This disease is very common, it has a number of symptoms that make it similar to many other ailments. Therefore, diagnosis is often difficult, especially in mild forms. The Epstein-Barr virus usually affects lymphoid tissue, so if mononucleosis is suspected, doctors first of all pay attention to the condition of the lymph nodes, liver, spleen, and tonsils. Only a special blood test can definitively confirm the diagnosis. If it is positive, other diseases that cause similar symptoms are excluded. With mononucleosis, an increased number of lymphocytes and the presence of atypical cells (mononuclear cells) characteristic of mononucleosis are found in the blood. The virus itself can be detected in saliva, even when six months have passed after recovery. The constant presence of the virus in saliva may indicate that a chronic process is taking place.

Treatment of mononucleosis

Therapy for infectious mononucleosis is aimed at alleviating unpleasant symptoms. For high fever, antipyretics are used, and nasal breathing is facilitated with vasoconstrictor medications. Regular gargling with warm salt water, a solution of soda or furatsilin greatly alleviates the condition.

Headaches are effectively relieved with acetaminophen or ibuprofen. Under the supervision of a doctor, patients take corticosteroids, which helps eliminate swelling of the throat, tonsils and spleen. Interferon, immunostimulants and other modern antiviral agents are prescribed.

The patient’s lifestyle during the acute phase of the disease is also of great importance. During this period, stress is harmful to the body; it is advisable to be in a state of complete rest.

That is, bed rest is recommended. Meals should be light and moderate so as not to place excessive stress on the liver. Eat little by little, several times a day, the diet should include proteins, vegetable fats, carbohydrates. It is very important to have enough vitamins.

Low-fat fish, dairy products, vegetable dishes, and various types of fruits are very suitable for this diet. It is not recommended to eat fried, salty and spicy foods.

During illness, heavy physical activity, overheating or, conversely, hypothermia are contraindicated. But light physical therapy and quiet walks in the fresh air will undoubtedly be beneficial; they will strengthen the immune system and speed up recovery.

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Complications and consequences of infectious mononucleosis

Herpes viruses are constant companions of humans. As a rule, by the time they reach adulthood, most of the population has already encountered them and suffered them in one form or another. However, an important question arises: how will this meeting go for the child and what might be the consequences?

The culprit of infectious mononucleosis

The Epstein-Barr virus, responsible for the development of infectious mononucleosis, belongs to the family of herpes viruses and is widespread throughout the world. Most often, encounters with it occur in childhood (from 3 to 14 years) and occur under the “mask” of an acute respiratory disease (acute respiratory disease) or are completely asymptomatic. Of course, this type of contact is the most successful. Especially because even mild cases form lifelong immunity.

Infectious mononucleosis is one of the clinical forms caused by the Epstein-Barr virus, heard by many parents. Teenage children are most often targeted, but younger children are also at risk of getting sick. The course of the disease is bright and long-lasting. Having been ill once, the memories remain for a long time.

Manifestations of infectious mononucleosis

Infectious mononucleosis is characterized by a certain set of manifestations:

  • Fever (increase in body temperature to 38-40⁰С);
  • Enlarged lymph nodes (mainly cervical);
  • Tonsillitis (inflammation of the tonsils);
  • Damage to the liver and spleen.

Parents are often alarmed by what they consider to be a persistence of symptoms that is too long. I would like to see my child completely cured of the hated virus as quickly as possible and prevent the disease from becoming chronic. Unfortunately, infectious mononucleosis does not go away quickly; it takes time for the body to recover.

The acute period of the disease lasts 2-3 weeks. Next comes the recovery stage, the duration of which varies from person to person and can last from several weeks to several months.

The sizes of the liver and spleen usually return to normal within a month after the onset of the disease.

Lymph nodes gradually shrink, but may remain enlarged for up to 2-3 months.

Fluctuations in temperature from normal to 37.5⁰C (low-grade fever), as well as weakness and drowsiness can be observed for several months (up to six months), although other symptoms have already completely passed.

During the recovery period, the child must be under the supervision of a specialist and undergo examination: blood tests (general and biochemical) - they reflect the dynamics of indicators changed in the acute period of the disease and serological markers (immunoglobulins M and G) - indicate recovery and the formation of immunity to the virus.

Complications of infectious mononucleosis

Fortunately, with infectious mononucleosis, complications rarely develop and the prognosis for recovery is favorable, but you need to know and remember about them:

The danger lies in massive internal bleeding. The sudden appearance of abdominal pain (especially in the left side), pallor of the face, dizziness and darkening of the eyes, possible fainting - these are signs that may indicate a ruptured spleen. This complication can be prevented by refraining from sports and physical activity for a month.

  • Attachment of a bacterial infection.

During the acute period, the body is exposed to bacteria. If they get on the mucous membranes, they can lead to the development of sinusitis (inflammation of the sinuses), bronchitis, or aggravate the course of tonsillitis.

Deterioration in general health, a new wave of fever, and increased sore throat may indicate a bacterial infection.

Excessively enlarged palatine tonsils, closing together, or lymph nodes, squeezing the neck from the outside, can block the path of air.

Noisy breathing, snoring, visible effort during inhalation and exhalation should alert you to the development of this complication.

Liver damage is characteristic of infectious mononucleosis, but the formation of jaundice (yellowness of the skin and sclera of the eyes, increased liver parameters in the blood) is considered a complication.

In rare cases, damage to the lining of the brain (meningitis) may occur. Persistent headache, nausea and vomiting, convulsions - these are the signs that characterize this condition.

Thrombocytopenia (decreased blood platelet levels) and anemia (decreased hemoglobin levels) are conditions caused by an inadequate response of the immune system that can complicate the course of infectious mononucleosis.

Immune system status

The Epstein-Barr virus infects various cells, but its main target is the B-lymphocytes of the immune system, which is why it is classified as a virus that leads to immunosuppression (decreased immune defense functions). However, such a condition in the case of infectious mononucleosis is transient, that is, temporary. Often the disease does not leave negative consequences - the functioning and numerical indicators of the immune system return to normal after about six months.

A general blood test, the monitoring of which is important both in the acute period and during the recovery stage, contains information useful not only to the pediatrician, but also to the allergist-immunologist. It gives an approximate idea of ​​the state of the immune system, because the leukocyte formula contains cells that are part of the immune system.

As the symptoms of the disease subside, blood counts return to normal. If deviations persist for a long time, this may be a reason to consult an allergist-immunologist and evaluate the “immune status” analysis. Also, observation by this specialist is necessary in case of severe infectious mononucleosis. The use of immunomodulatory drugs (that affect the immune system in one way or another) is possible only as prescribed by an allergist-immunologist, strictly according to indications.

Outcomes and consequences

In case of complete recovery, the Epstein-Barr virus remains in the body forever under the control of the immune system and does not cause any symptoms. However, if immunity is reduced, then a chronic condition may develop (prolonged fever, frequent bacterial, viral and fungal infections) or a relapse of the disease in a milder form.

The consequences of infectious mononucleosis, caused by an inadequate response of the immune system (the formation of antibodies against the body’s own tissues), are diseases such as: systemic lupus erythematosus, nephritis, thyroiditis and others.

According to modern research, a connection has been established between the Epstein-Barr virus and the development of cancer: nasopharyngeal carcinoma, lymphoma (an increase in the titer of serological markers of the virus in the blood, associated with an oncological process). However, the likelihood of such a consequence is low and is determined not only by the presence of the virus in the body, but by other factors.

Despite the fact that infectious mononucleosis is a disease that usually occurs without complications, it requires careful attention, competent treatment according to the doctor’s plan and monitoring throughout the entire recovery period.

— Under the supervision of which specialists should a child who has had infectious mononucleosis be under the supervision and for how long?

— You need to understand that infectious mononucleosis, despite its widespread prevalence and generally mild course, is a disease with many possible long-term consequences. In this regard, a child who has had an infection confirmed by laboratory methods requires close monitoring.

A child who has had an Epstein-Barr viral infection (EBV infection) should at least be under the supervision of a local pediatrician at the clinic and an infectious disease specialist. Inspections must be performed once a month. If there are indications, additional consultations with other specialists are also possible: from an ENT specialist to a hematologist and oncologist. Consultation with specialists is necessary if complications of the disease are detected or if there is a suspicion of any change in the relevant organ system.

Within six months to a year (until complete recovery), you must undergo the following studies:

  1. Complete blood test;
  2. PCR blood test (polymerase chain reaction;
  3. Serological markers of EBV using ELISA (enzyme immunoassay);
  4. Immunogram;
  5. Take an oropharyngeal swab;
  6. Other tests as prescribed by your doctor.

Additional tests are prescribed if there are signs of damage to a particular system. For example, studying the level of liver enzymes for signs of viral hepatitis.

— When can routine vaccination be resumed?

— After a EBV infection, a person is given a medical exemption from vaccinations and exemption from physical education for 6 months. These recommendations should not be neglected, since one of the features of the course of infectious mononucleosis is the presence of hepatolienal syndrome, i.e., enlargement of the spleen and liver with stretching of their capsules. Increased physical activity (physical education, wrestling, dancing, etc.) can lead to overstretching of an already stretched and thinned capsule, which can cause it to rupture. This condition requires emergency surgery.

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More about infectious mononucleosis in adults

The development of mononucleosis in adults is a serious problem that can lead to serious complications. In addition, mononucleosis is easy to become infected with, and it is important to understand how the Epstein-Barr virus, which is most often the causative agent of infectious mononucleosis, is transmitted. And also how it is treated. Today we will look at mononucleosis in adults, its symptoms and treatment, and also talk about the causes, diagnosis and possible complications of the disease.

Causes

Infectious mononucleosis in adults develops due to the causative agent – ​​the Epstein-Barr virus. The virus infects the surface epithelium of the mucous membrane of the mouth and throat, entering the human body through the respiratory system. In close contact with the infected mucous membrane, B-lymphocytes are also easily exposed to viral infection, which, having settled in them, begins to actively multiply. As a result, the formation of atypical mononuclear cells occurs. They successfully reach the nasopharyngeal and palatine tonsils with the bloodstream, and also reach the liver, spleen and lymph nodes.

Absolutely all of the listed organs consist of immune, that is, lymphoid, tissue. Based on them, the virus also begins to actively reproduce and constantly provoke their significant growth.

The patient suddenly develops a fever and develops a sharp sore throat. You can only catch the dangerous Epshetain-Barr virus from an infected person. Even a seemingly healthy person can easily become a source of a viral disease if there is an infection in his saliva. This person is a virus carrier.

There are several reasons for an adult to become infected with the Epstein-Barr virus, such as:

  • the virus found in saliva is transmitted through airborne droplets when coughing or sneezing;
  • kissing is a significant method of contact infection;
  • a sign of household infection is the common use of various household items (dishes, towels, toothbrush, for women - lipstick and other items);
  • mononucleosis in adults can be present in both saliva and semen, so the virus can be transmitted through sexual contact;
  • during the procedure of transfusion of infected blood, mononucleosis can hide the risk of infection and can be easily transmitted through the blood to a healthy person;
  • transplantation of internal organs from a virus carrier.

Sometimes mononucleosis in both adults and children is diagnosed as ARVI. In such cases, the virus could be dormant or the disease was transmitted in the weakest form possible. For this reason, 90% of the population may not show clear signs of the disease.

Mononucleosis can occur in the form of regular systematic cases. The risk group includes both all family members and all members of the team where an outbreak of mononucleosis infection actually occurred; HIV-infected people. The disease is recorded everywhere throughout the entire year. But significant incidence is recorded in the spring and autumn seasons. Mononucleosis primarily affects people between twenty and thirty years of age. The symptoms and treatment of mononucleosis in adults differ from other diseases. The manifestations of this disease and the treatment procedure have distinctive features.

Symptoms

Once the virus has actively entered the human body through the mucous membranes of the throat or nasopharynx, as well as through the digestive system, during the incubation stage (from 4 to 14 days - a week on average), the virus passes into the blood and lymph nodes. First, the infected person experiences severe somatic malaise, general weakness, immense muscle aches and a hellish headache, as well as severe pain in the throat when swallowing.

Symptoms of the disease appear one after another during the most difficult period of the height of infectious mononucleosis:

  • as a rule, all these symptoms appear almost immediately, with an increase in body temperature from 38.5 to 39.5 degrees, sometimes reaching 40 degrees;
  • In addition, in the throat of the sick person, reddening of the hyperemic and loose tonsils begins, which become covered with a gray coating. These symptoms of mononucleosis in adults are very similar to the signs of tonsillitis;
  • the anterior and posterior lymph nodes in the neck are enlarged;
  • The patient may notice an increase in lymphatic ulnar, tracheobronchial, axillary and inguinal nodes, reaching a size from the size of a bean to the size of a walnut. As a rule, the size of the lymph nodes becomes normal after a few weeks, less often after a few months, in exceptional cases - after a year;
  • mononucleosis is also characterized by an enlargement of the spleen - noted on days 7-9 and liver - recorded on days 9-10;
  • changes in the peripheral blood picture (leukocytosis - increase in the number of leukocytes).
The peak of mononucleosis in adults occurs within 2-4 weeks. Recovery time occurs within 3-4 weeks, accompanied by severe fatigue and drowsiness.

Diagnostics

In case of acute tonsillitis syndrome and the occurrence of atypical mononuclear cells in the blood, infectious mononucleosis is diagnosed. The presence of infection is suspected based on the general clinical picture. The following methods are used to confirm the diagnosis:

  1. Conducting a serological blood test for antibodies to mononucleosis; during infection, an increased titer of class M immunoglobulins is recorded, when the detection of only anti-EBV IgG is an indicator of a previous illness, and not a characteristic acute process.
  2. The laboratory carries out an accurate determination of membrane and capsid Epstein-Barr virus antigens in the blood.
  3. Buccal scraping from the mucous membranes inside the cheeks and PCR examination of the blood;
  4. To clarify the severity of the disease, it is necessary to donate blood for biochemical tests.
  5. A chest x-ray is taken.
  6. Ultrasound of the abdominal cavity.
  7. In the acute stage of the disease, testing for HIV infection is necessary.

If mononucleosis is suspected, consultations with specialists such as a surgeon (for abdominal pain) are also necessary; hematologist; neurologist.

Treatment

With the correct differential diagnosis of infectious mononucleosis in adults, it will not be difficult to determine how to treat this disease. It is worth paying attention to the fact that it is imperative to contact the clinic in a timely manner, where only a qualified specialist will prescribe the correct treatment.

So, you can treat mononucleosis in adults using the drugs described in the table.

Antiviral and immunomodulators.

  • Imudon,
  • Anaferon,
  • Viferon,
  • Arbidol.
  • Zodak,
  • Suprastin,
  • Diazolin.

Vasoconstrictors for the nose.

  • Sanorin,
  • Naphthyzin.

For swelling of the tonsils.

  • Prednisolone,
  • Dexamethasone.
  • Ibuprofen,
  • Paracetamol,
  • Nimesulide.

To support the liver.

  • Antral,
  • Essentiale Forte.
  • B,
  • C,
  • P.

Antiseptics for treating throat.

  • Miramistin,
  • Chlorophyllipt,
  • Furacilin.

For the treatment of sore throat.

To fully restore the body, nutrition for mononucleosis should correspond to a light diet. To do this, you will need to eat healthy food - cereals, dairy products, fish, fresh vegetables and fruits, eggs, cheeses, cottage cheese, homemade compote, warm teas, light soups, boiled meat products. Completely exclude coffee, alcohol, pickled, salty and fried foods from your diet. A sign of proper recovery is effective, specialized hygiene products for body care.

ethnoscience

After preliminary differential diagnosis and prescription of drug treatment, the effectiveness of treatment with folk remedies can be effectively supported. Medicinal herbs and other non-traditional methods can perfectly complement medications and increase their effect. It is recommended to use decoctions prepared from medicinal herbs:

  1. Take the same proportion of edelweiss grass; cornflower flowers; burdock, elecampane and chicory roots. Grind everything thoroughly. Pour 3 tablespoons of the mixture into a suitable container and brew with a liter of boiling water. Leave for 12 hours. Then strain. Take 0.5 cups half an hour before meals. The maximum course of treatment with decoction is about two months.
  2. Using the same recipe, you can prepare a decoction of calendula, chamomile flowers, yarrow, string and immortelle, as well as coltsfoot herbs. Take according to the same system.

Mononucleosis requires an additional, special approach to the recovery process (more time for rest, good sleep, decent rest).

Prevention

Currently, medical science has not yet created a specific vaccine against mononucleosis. Therefore, disease prevention is extremely important. Preventing infectious disease includes:

  • following strict rules of personal hygiene;
  • use of individual cutlery;
  • using a personal toothbrush;
  • scrupulous examination of donor blood for the presence of the virus.

In addition, you should not forget about strengthening the immune system:

  • do hardening;
  • do exercises;
  • exercise;
  • be in the fresh air more often;
  • take vitamins comprehensively.

Considering that a person has already had mononucleosis in childhood or adolescence, the possibility of a dangerous relapse in adults is unlikely.

Complications

  1. Possible complications. Internal retinal hemorrhage; hepatitis; nephritis (kidney inflammation); damage to glandular connective tissue; secondary purulent complications; inflammation of the testicles; thyroid gland; pancreatitis; mumps; respiratory failure; splenic rupture; enlargement of paratracheal lymph nodes.
  2. From the blood side. Autoimmune anemia; decrease in the number of leukocytes; decreased platelet levels.
  3. Nervous system. Bell's palsy; Guillain-Barré syndrome; hallucinations, depression; excitation; mental disorders; inflammation of the cranial and peripheral nerves; spinal cord damage; encephalitis.

To summarize, it is worth recalling that despite the above list of drugs for the treatment of mononucleosis, you do not need to approach therapy on your own. You need to trust your doctor. Treatment of mononucleosis in adults may occur differently than in children, so you should not rely on child treatment methods. You should also engage in restoration of the body and support it with the help of traditional medicine.

Source: http://herpess.ru/zabolevaniya/mononukleoz-u-vzroslyh.html

Symptoms and consequences of infectious mononucleosis

Infectious mononucleosis is a widespread viral infection characterized by damage to lymphoid and reticuloendothelial tissue. The disease more often manifests itself in the cold season. In 90% of adults, antibodies to the causative agent of the disease are detected in the blood, which indicates that the person has suffered an infection in one form or another.

Cause of the disease

The causative agent of infectious mononucleosis is the DNA-containing Epstein-Barr virus. This is a type 4 virus from the herpes virus family. Its peculiarity is that after the virus enters the human body, the virus remains in it forever, and it is impossible to get rid of it.

Moreover, it does not matter whether the person suffered a full-blown form of mononucleosis after the initial infection or whether an asymptomatic carrier of the virus has developed. When immunity decreases under the influence of various factors, the virus becomes more active and causes a relapse of the disease.

Most often, infection occurs in childhood (up to 10 years) or adolescence.

By the age of 40, most people already have antibodies to the virus, so primary infectious mononucleosis after 40 years of age is extremely rare in adults. The development of clinical manifestations in adults may be a relapse of a long-standing infection.

Unlike other herpes viruses, the culprit of infectious mononucleosis does not destroy the cell it affects (B-lymphocyte, a type of white blood cell), but multiplies in it and enhances its growth.

The virus is released from the body of a patient or virus carrier, who is the source of infection, when coughing, sneezing, talking with droplets of nasopharyngeal mucus and saliva. The virus enters the body of a healthy person through inhaled air, through kissing, or when using shared utensils or towels.

The virus dies quickly outside the human body, so the condition for infection is close contact, despite high susceptibility to the virus. Given the low contagiousness of the virus, scattered cases of the disease are recorded; in rare cases, small outbreaks may occur.

When entering the body of a healthy person, the virus first lingers on the epithelial cells of the oropharynx.

Then the pathogen penetrates the blood and is carried into the lymph nodes with the blood, as it has an affinity for lymphoid tissue. The virus can remain in an inactive state for decades, remaining in the epithelium of the oropharynx and in B lymphocytes.

The virus is released in saliva from the end of the incubation period, throughout the acute period of the disease, and for a long time after clinical recovery (6 months or more). Prolonged viral shedding after primary mononucleosis is observed in 10-20% of patients.

Symptoms

When infected at an older age, mononucleosis does not have significant symptoms. Since most adults already have antibodies to the virus, the classic course of the disease does not occur often.

Infectious mononucleosis in adults can begin with fever and sore throat, which patients regard as a common sore throat. There is general weakness, poor general health, and lack of appetite. An interesting fact is that the desire to smoke disappears in smokers.

The enlargement of lymph nodes (cervical, inguinal, axillary) gradually increases - they become noticeable upon external examination. Sore throat and cervical lymphadenitis are typical symptoms of mononucleosis. The reddened tonsils in the pharynx are enlarged, loose, with purulent deposits, easily separated from the mucous membrane. There may be hemorrhages and granularity on the back wall of the pharynx.

Enlarged lymph nodes are characterized by:

  • elastic consistency;
  • mobility;
  • mild pain when palpated.

The nature of the fever can be different: it can reach high numbers (up to 40 0 ​​C), be wavy or constant. In some patients it changes during the day (there is a decrease in the morning hours to normal). Fever is accompanied by severe headache. The duration of fever can vary, sometimes up to a month.

In most patients, an enlargement of the spleen and liver appears already in the initial period of infection. Their maximum size is observed by the 7-10th day of illness. This is accompanied by a feeling of discomfort in the right and left hypochondrium.

When palpated, the liver is painful, protrudes below the costal arch, and has a dense consistency. The appearance of a jaundiced coloration of the mucous membranes and skin, and dark urine indicate the development of hepatitis (it develops in 5-10% of adult patients). Elevated levels of enzyme activity indicate liver dysfunction.

The enlargement of the spleen can be significant. It is dangerous due to its complication - rupture of the capsule with the development of massive bleeding. In such cases, urgent surgery to remove the spleen is required.

When the spleen ruptures, the following symptoms occur:

  • severe weakness;
  • darkening of the eyes;
  • nausea;
  • rapid pulse;
  • decreased blood pressure;
  • vomit;
  • Increasing diffuse abdominal pain.

Often a rash appears on the body in the form of pink spots or nodules and is not accompanied by itching. The appearance of itching during the rash indicates an allergic nature of the rash (to any drug, especially often to a penicillin antibiotic).

Other symptoms may also appear: neurological disorders (cranial nerve palsies), inflammation of the heart and lung muscles, etc.

The acute period lasts 2-4 weeks, after which the symptoms gradually subside. First, the temperature normalizes, then the size of the lymph nodes and internal organs. Changes in blood tests may persist for several weeks (sometimes months).

Diagnostics

The disease can be suspected based on the leading signs of mononucleosis:

  • enlarged lymph nodes;
  • enlarged spleen and liver;
  • temperature reaction;
  • tonsillitis;
  • rash.

Peripheral blood examination indicators are important for diagnosis - an increase in the total number of leukocytes, the number of lymphocytes (up to 15% above normal) and the detection of atypical mononuclear cells in quantities above 10%.

But such changes can also be caused by other viral infections, with which the doctor will differentiate infectious mononucleosis.

A number of serological blood tests are used over time to track the appearance of class M immunoglobulins (they are formed from the 5-7th day of infection and persist for about a month) and class G immunoglobulins (appear after 3 or more weeks and persist throughout life). By analyzing the dynamics of antibody titers, primary mononucleosis can be established.

The use of qualitative and quantitative PCR methods can also help in the differential diagnosis of the disease.

In case of pronounced changes in the peripheral blood, a consultation with a hematologist is indicated to exclude leukemia and lymphogranulomatosis.

Treatment

Treatment of mononucleosis in adults with mild and moderate course of the disease is carried out at home. Since there are no specific antiviral drugs that can have an effect on the pathogen and quickly cope with the disease, symptomatic or syndromic treatment of infectious mononucleosis is carried out.

The antiviral drugs and immunomodulators offered by the pharmacy do not have a pronounced effect and do not affect the duration of clinical manifestations.

At high temperatures, NSAIDs are used, which also have anti-inflammatory and analgesic effects (Ibuprofen, Paracetamol, Nurofen, Nice).

What to treat and how to treat mononucleosis is decided by an infectious disease doctor in each specific case. The need for bed rest depends on the severity of the process. In case of severe manifestations of hepatitis, detoxification therapy is carried out either oral (in the form of drinking plenty of fluids) or using intravenous infusions of solutions.

  • hepatoprotectors (Essentiale Forte, Enerliv, etc.);
  • diet therapy (exclusion of broths, fried, spicy, fatty foods, smoked foods, seasonings, alcohol of any quality and quantity);
  • sorbents (Enterosgel, Polysorb, etc.).

For the treatment of acute tonsillitis the following are used:

  • antibiotics macrolides or cephalosporins;
  • gargling with antiseptic solutions:
  • desensitizing drugs (Kdaritin, Cetrin, Tavegil, etc.);
  • preparations for local treatment (Decatylene, Antiangin, Strepsils, etc.);
  • probiotics and prebiotics to prevent dysbiosis (Yoghurt, Bifiform, Bifidobacterin, etc.);
  • vitamin complexes.

For the hypertoxic form of mononucleosis, a short course of glucocorticosteroids is used (Prednisolone for up to 5-7 days).

In severe cases and the threat of asphyxia develops due to severe swelling of the larynx, a tracheotomy is performed and a ventilator is connected.

Consequences of mononucleosis

After the main manifestations of the disease have subsided, the fever may persist for several weeks, and swollen lymph nodes may persist for up to a month.

The disease is especially dangerous for pregnant women, as it can cause premature termination, cause infection of the fetus with the development of respiratory distress syndrome in the child, recurrent sepsis, disorders of the nervous system and vision.

Infectious mononucleosis, despite a generally favorable prognosis, can take a chronic form in adults with the development of exacerbations. The course of the disease is especially unfavorable in HIV-infected people.

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