Mononucleosis in adults: symptoms and treatment Komarovsky

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Dr. Komarovsky about the symptoms and treatment of mononucleosis in children

When a child is born, his immune system begins to “study” all the surrounding dangers. So, gradually, when faced with certain viruses, of which there are several hundred on the planet, protection is developed in the form of antibodies to viruses.

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Infection with some agents is difficult to miss, and some diseases go unnoticed or almost unnoticed by the parents of the baby. Quite often, many mothers and fathers do not even suspect that the child has had infectious mononucleosis. The authoritative doctor Evgeny Komarovsky tells whether it is possible to determine the symptoms of this disease in a child, and what to do if the diagnosis is confirmed.

About the disease

Infectious mononucleosis is a viral disease. It is caused by the Epstein-Barr virus, which is a common agent and is, in fact, a type 4 herpesvirus. This “elusive” virus comes into contact with the world’s population much more often than people might think; as a result, more than 90% of adults have been infected with it at some time. This is evidenced by the presence of antibodies in the blood.

Similar antibodies, indicating that there has been infection and immunity has developed, are found in approximately 45-50% of children aged 5-7 years.

The virus thrives in certain cells of the human body - lymphocytes. There it quickly replicates under appropriate favorable circumstances, which include weakened immunity. Most often, the virus is transmitted through bodily fluids - saliva, for example, for this reason its infectious mononucleosis is often called the “kissing disease.” Less commonly, the virus is transmitted by airborne droplets.

The pathogen is transmitted through blood transfusions, organ and bone marrow transplantation operations, as well as from a pregnant mother to the fetus through the general bloodstream.

Infectious mononucleosis is an acute viral disease; it does not have a chronic form. From the affected lymph nodes, the virus quickly spreads throughout the body, affecting internal organs that have lymphoid tissue in their structure.

Symptoms

In 90% of cases, infectious mononucleosis in children occurs in a mild form, says Evgeny Komarovsky, and therefore it is rarely diagnosed. Children under 2 years of age suffer from this disease infrequently, and in the vast majority of cases the disease is mild. Children aged 3 years and older experience the disease much more severely, with boys getting sick more often than girls. Medicine cannot answer why this is so, but the fact is obvious.

After the mononucleosis virus enters a child’s body, the foreign agent can behave peacefully for quite a long time. It’s all about the baby’s immune system. If the natural defense is strong, then one and a half or two months may pass. If the body is weakened, then the symptoms of the onset of the disease may appear within 5-6 days.

According to Evgeniy Komarovsky, the very first sign is enlarged lymph nodes. All groups of nodes increase to varying degrees, but most strongly are the cervical, submandibular, and occipital ones. An ultrasound scan at this time can reveal an increase in the size of the spleen and liver (these organs consist of lymphoid tissue). And clinical blood tests will reveal an altered lymphocyte formula.

Immediately after this, the lymphoid tissue in the nose begins to become inflamed and increase in size (swell), and the tonsils become inflamed. The child's nasal breathing is impaired, he breathes mainly only through his mouth, and severe night snoring appears. The child may complain of a sore throat.

Common symptoms that mislead both parents and doctors are nonspecific:

  • Lack of or decreased appetite.
  • Tearfulness, moodiness, lethargy.
  • Increased body temperature.
  • Pain when swallowing.
  • Feeling of “ache” in the body.

All these symptoms together and some of them individually can arouse suspicion among attentive parents and the called pediatrician. You should definitely do a blood test. Lymphocytes that are affected by the virus cease to be such and turn into new cells, which a healthy child does not and cannot have in the blood. These abnormal cells are called atypical mononuclear cells. If the laboratory technician finds them in the baby’s blood, the diagnosis will be fully confirmed. In addition, the number of leukocytes and monocytes in the blood will increase.

The danger of the disease lies not even in the disease itself, but in possible concomitant infections. When lymphoid tissue, which plays a critical role in the child’s immune system, is affected, the body becomes more vulnerable than usual to various viruses and bacteria. This can be dangerous from the point of view that a secondary disease can easily begin, any one, depending on the microbe or viral agent that has “attached”. More often, complications are bacterial in nature: sore throat, otitis media, pneumonia.

Komarovsky about treatment

The disease cannot be called fleeting. The acute phase lasts from 2 to 3 weeks, for some - a little longer. The child’s well-being, of course, at this time will not be the best, and sometimes quite difficult. You need to be patient, because infectious mononucleosis passes in all children without exception.

Uncomplicated mononucleosis does not require any special treatment. If the child feels well, then there is no need to give anything other than plenty of fluids. If the baby’s condition is disappointing, the doctor may prescribe hormonal anti-inflammatory drugs. There is no cure for mononucleosis as such, so treatment should be exclusively symptomatic: sore throat - gargle, nose is not breathing - instill saline solution, moisturize the mucous membranes of the bronchi to avoid complications from the respiratory system.

Komarovsky does not see any advisability in taking antiviral drugs, since they will not have any effect on the herpes virus type 4, but will significantly “hit” the parents’ pockets. In addition, the situation with clinically proven effectiveness of antiviral drugs is quite deplorable. For the same reason, there is no point in giving a child homeopathic medicines with a claimed antiviral effect. Of course, there will be no harm from them, but you shouldn’t expect any benefit either.

Treatment should be based on creating favorable conditions conducive to the child’s speedy independent recovery:

  • In the acute stage of the disease, the baby needs rest and bed rest;
  • The child should breathe humidified air (relative humidity in the room - 50-70%);
  • It is necessary to provide plenty of warm fluids throughout the acute period;
  • Do wet cleaning in the child’s room more often, without using household chemicals that contain chlorine;
  • At high temperatures, the child can be given Paracetamol or Ibuprofen.

When the temperature becomes normal, you can and should take walks in the fresh air more often, while refraining from visiting playgrounds and crowded places, so that the child does not infect others and does not “catch” another infection due to his weakened immune system.

During treatment, you should adhere to a therapeutic diet, excluding all fatty, fried, smoked and salty foods, as well as spicy, sour and sweet foods from the child’s diet. In the acute stage, with difficulty swallowing, it is best to give vegetable soups, purees, milk porridges, cottage cheese. During the recovery stage, it is not necessary to puree all food, but the ban on the above products remains in force.

If bacterial complications are “joined” with mononucleosis, they can and should be treated exclusively with antibiotics. Parents should know that if a doctor prescribes Ampicillin or Amoxicillin, which is popular in pediatrics, the child will have a 97% chance of developing a rash. Why this reaction occurs is currently unknown to medicine. We can only say with certainty that this rash will not be an allergy to an antibiotic, nor a symptom of a separate disease, nor a complication. It just appears and then goes away on its own. This shouldn't be scary.

Recommendations of Dr. Komarovsky

Parents must report the fact of infectious mononucleosis to the preschool institution that their child attends, or to school. But this disease does not require quarantine. The premises will simply require more frequent wet cleaning.

Recovery from infectious mononucleosis is a rather lengthy process, and the immune system is greatly weakened. For the next year (sometimes for six months), the treating pediatrician cancels all scheduled vaccinations for such a child. It is not recommended for a child to stay in close children's groups for a long time. You should not take your baby to the sea to “correct” his immunity, since severe acclimatization after suffering a viral illness is guaranteed. During the year, it is not recommended to walk in the sun or attend sections where there is strong physical activity.

The body should be supported in the recovery process with vitamin complexes approved by age.

After an illness, a child should be seen by a doctor more often. The virus has oncogenic activity, that is, it can contribute to the development of oncological tumor diseases. If, after an illness, the same modified mononuclear cells continue to be found in the baby’s blood tests for a long time, the child will definitely need to be shown and registered with a hematologist.

After an illness, persistent lifelong immunity is developed to the virus that causes infectious mononucleosis. It is impossible to get the disease again. The only exceptions are HIV-infected people; they can have any number of episodes of acute illness.

Patient reviews

Most parents whose children have suffered from this disease claim that the longest and most painful period was the diagnosis, since doctors are in no hurry to make an accurate diagnosis. For many patients who are not sent for treatment to an infectious diseases hospital due to the mild stage of the disease, doctors recommended taking antiviral drugs.

Patients who were treated at home using the Komarovsky method claim that there were no complications, the disease went away quite quickly and was tolerated relatively easily by the child.

Below is a video with recommendations from Doctor Komarovsky himself.

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Source: http://www.o-krohe.ru/komarovskij/mononukleoz-u-detej/

Infectious mononucleosis in children (Komarovsky)

Infectious mononucleosis is a fairly common diagnosis in pediatrics. However, this disease also occurs in adult patients. Information about it is often contradictory.

Infectious mononucleosis

Despite the fact that the disease is common, many doctors argue about the diagnosis and treatment of the disease.

Quite complete and accessible information about infectious mononucleosis in children, its symptoms and treatment from Komarovsky, a famous Ukrainian pediatrician and infectious disease specialist. He devoted a number of articles for parents to this disease.

This pathology has other names:

  • Glandular fever.
  • Filatov's disease.
  • Monocytic tonsillitis.

The causative agent of the pathology is the Epstein-Barr virus (Epstein-Barr). It rarely causes illness in children under two years of age, but infectious mononucleosis is common in older adults.

The disease is transmitted by airborne droplets, but epidemic outbreaks are not typical for this disease. Infection usually requires closer contact, such as kissing.

The incubation period can be long - from 4-5 days to several weeks. After entering the body, the virus is found mainly in lymphoid tissue.

Damage to lymphoid tissue

Lymphoid tissue is the favorite site of localization of the Epstein-Barr virus. Evgeny Komarovsky focuses the attention of parents on this feature of mononucleosis, since this is what is associated with possible complications and health problems for the child in the future.

Almost all groups of lymph nodes are involved in the pathological process. They increase in size and become accessible to palpation. Sometimes they may be painful. In addition, with infectious mononucleosis, the spleen and even the liver sometimes become enlarged. Doctors refer to this as “hepatosplenomegaly.”

Since lymphoid tissue is responsible for the normal functioning of the immune system, its damage leads to a weakening of the body's defenses. After this illness, bacterial complications and repeated viral infections are not uncommon.

According to Komarovsky, any vaccinations are not recommended for children within six months after this disease, except for epidemic indications. This is due to the unpredictability of the immune system’s response to the vaccine.

However, parents should know that, according to official data, previous infectious mononucleosis in children is not a contraindication to vaccination and cannot serve as a reason for medical withdrawal.

Symptoms

Infectious mononucleosis is characterized by a number of symptoms. These include:

  • Fever. The temperature can reach 39–40°.
  • Sore throat.
  • Enlarged lymph nodes.
  • Poor general health.

When examining the oropharynx, enlarged tonsils are determined - tonsillitis. It can be catarrhal or lacunar, in severe cases – ulcerative-necrotic. Infectious mononucleosis, according to Komarovsky, is very often confused with streptococcal sore throat, which leads to improper treatment.

Palpation of the cervical, submandibular, axillary, and inguinal lymph nodes reveals their enlargement.

The inflammatory process can also affect the lymph nodes of the mesentery with the development of a picture of acute mesadenitis. In this case, patients will complain of acute abdominal pain.

Diagnostics

Since the clinical picture of infectious mononucleosis is similar to that of acute tonsillitis and tonsillitis, diagnostic errors are quite likely. A reliable diagnostic method is a general blood test.

In the leukocyte formula of patients, characteristic cells will be determined - atypical mononuclear cells. They are the ones who make it possible to establish the correct diagnosis.

If an enlargement of the liver and spleen is suspected, an ultrasound of the abdominal organs is prescribed. In addition, sometimes the doctor refers the patient for a biochemical blood test to assess liver function.

To exclude diphtheria, it is necessary to take a swab from the oropharynx and examine it in the first days of the disease.

Treatment

Since this is a viral disease, there is no etiotropic therapy for it. In children, treatment of infectious mononucleosis is mainly symptomatic:

  • antipyretic drugs;
  • local treatment of the throat;
  • anti-inflammatory tablets and sprays;
  • analgesics.

Evgeny Komarovsky in his articles mentions the ineffectiveness of antibiotics for infectious mononucleosis.

In addition, this treatment leads to the appearance of a rash (exanthema) on days 3–5. This happens when using antibiotics from the penicillin group. Most often, if a sore throat is mistakenly diagnosed, amoxicillin or amoxiclav is prescribed. But a viral infection cannot be treated this way, which some pediatricians forget.

Oncogenicity of the virus

Komarovsky says that the virus has increased oncogenicity. This is true. However, all malignant neoplasms caused by the Epstein-Barr virus are not forms of infectious mononucleosis. These are separate diseases; they only have a common pathogen. The most common of these in childhood is Burkitt's lymphoma.

And yet, in domestic medicine, all children with long-lasting changes in the blood after an illness are subject to follow-up with a hematologist.

Timely diagnosis of infectious mononucleosis allows the doctor to treat correctly, and the patient to recover quickly and without complications.

Source: http://elaxsir.ru/zabolevaniya/drugie-zabolevaniya/mononukleoz-u-detej-simptomy-i-lechenie-komarovskij.html

Mononucleosis in children: what Dr. Komarovsky advises

Infectious mononucleosis in children is quite common. Parents may mistake it for a sore throat or cold. How to distinguish the symptoms of mononucleosis in children from other diseases and how to properly treat your baby? The advice of Dr. Komarovsky will help with this.

What is infectious mononucleosis in children?

First, a little theory. Mononucleosis is a viral disease caused by the Epstein-Barr virus. Most often, mononucleosis affects children aged 3-10 years. Infectious mononucleosis occurs less frequently in children under 2 years of age. If your baby has a sore throat, inflamed tonsils, he starts snoring at night, and his breathing is difficult during the day, he may have infectious mononucleosis. The disease is also accompanied by enlargement of the lymph nodes, liver and spleen in the child. These are typical symptoms of mononucleosis in children. In addition, the sick child has a high temperature and is lethargic. A blood test helps accurately distinguish infectious mononucleosis in children from other diseases.

Epstein-Barr virus is usually transmitted through saliva. A child can become infected through kissing, through toys, or through airborne droplets. This virus is not very contagious, and in children infectious mononucleosis is not as common as, for example, ARVI. But by the age of 5, at least 50% of children have antibodies to this virus in their blood. This means that the child has already encountered infectious mononucleosis. In many cases, his parents did not even know about it, since often the disease occurs with almost no symptoms. Anyone who was not sick as a child gets sick as an adult.

A sick child experiences symptoms of mononucleosis for about 2-3 weeks, and then he recovers, no matter how bad he feels.

How to distinguish the symptoms of mononucleosis in a child from a sore throat?

An experienced doctor will always distinguish mononucleosis in a child from another disease and will not give the child unnecessary medications. But it is better for parents to have the information themselves.

Parents can easily confuse this disease with a sore throat. But as Dr. Evgeny Komarovsky emphasizes, mononucleosis in children is accompanied by nasal congestion and runny nose. With a real sore throat there is never a runny nose. When a child has a sore throat, but his nose is blocked, it is most likely mononucleosis.

Treatment of mononucleosis in children: advice from Dr. Komarovsky

The main thing that every mother should know is that infectious mononucleosis cannot be treated with antibiotics, as it is a viral disease. If you give a child the antibiotics ampicillin or amoxicillin with mononucleosis, thinking that he has a sore throat, then in most cases he will develop a rash all over his body. Before prescribing an antibiotic for a sore throat, the doctor will find out whether the nose is stuffy.

As Dr. Komarovsky notes, mononucleosis in children is treated symptomatically. This means that if the child has a fever, you need to give your child an antipyretic; if the throat hurts, gargle. No quarantine needed. Since the Epstein-Barr virus does not cause lasting immunity, you can get mononucleosis again.

When can children go to kindergarten after treatment for mononucleosis?

You can breathe a sigh of relief when, after mononucleosis, atypical mononuclear cells disappear from the blood. As a rule, a routine clinical blood test is taken at intervals of 7-10 days after illness. Since mononucleosis affects the lymphoid system, which is the immune system, infectious mononucleosis in children may reduce the content of leukocytes in the blood - cells that protect the body from disease. If, after an illness, a child has to go to kindergarten or school, you need to make sure that the number of leukocytes is normal. A blood test will show this.

In order for a child to recover faster from infectious mononucleosis, it is necessary to protect him as much as possible from other diseases. Therefore, try to walk more with your child in the fresh air and avoid contact with other children, advises Dr. Komarovsky. But taking immunostimulants has no proven effectiveness.

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INFECTIOUS MONONUCLEOSIS

- What kind of disease is this? - asked Signora Countess the Elder. She loved to be treated, and as soon as she heard the name of some new, unknown disease, she immediately found it in herself. After all, the countess was so rich that the costs of doctors and medicines did not frighten her at all.

The infectious mononucleosis virus is quite widespread. This disease is not at all rare, but it usually occurs in mild forms, and these mild forms are very difficult to diagnose.

The fundamental feature of the virus is its “love” for the so-called lymphoid tissue[1]. What is lymphoid tissue and where is it located? Yes, almost everywhere! These are all (!) lymph nodes, tonsils, liver, spleen. And all these organs are affected by mononucleosis.

Children under 2 years of age rarely get sick with mononucleosis, and if they do get sick, it is usually mild. The favorite “victims” of mononucleosis are children over 3 years old and not very old adults (up to 40).

The virus is released into the external environment with the saliva of the patient. The easiest way to become infected is through kissing or through toys, but it can also be transmitted through airborne droplets. The virus is not very contagious and diseases almost never have the character of epidemics - more and more isolated cases. But for some reason these “isolated cases” are more common in boys. The incubation period is very variable and is largely determined by the state of immunity of the infected person: the approximate interval is from 5 days to 2 months.

Symptoms of mononucleosis are determined by inflammatory processes in those organs that are affected by the virus: all groups of lymph nodes increase, some more, others less, but all of them increase - most of all the cervical ones. In turn, the liver and spleen enlarge. Inflammation of the tonsils (angina) appears, swelling of the adenoid tissue (in the nose) leads to the fact that the child, firstly, breathes through the mouth, and secondly, begins to snore terribly. In addition to all these specific mononucleosis symptoms, there are also general non-specific signs - the temperature rises, you don’t want to eat, it hurts to swallow, lethargy, etc.

A clinical blood test helps greatly in establishing the diagnosis of infectious mononucleosis. The fact is that the mononucleosis virus specifically affects blood cells and when examining it (blood), doctors find special cells that are not normally present. These cells are called “atypical mononuclear cells” - from the word “mononuclear cells” and, by the way, the name of the disease itself.

Thus, a typical mononucleosis looks like this: sore throat + snoring at night with difficulty breathing during the day + enlarged liver, spleen and lymph nodes + changes in the blood.

— The acute period of the disease lasts, on average, 2-3 weeks and, no matter how bad it is, everyone recovers.

— The lymphoid system is one of the most important parts of the immune system. It is not surprising that its defeat makes a person very vulnerable to other infections. In short, against the background of mononucleosis, it is very, very easy to “catch” another disease. Hence the frequency of complications caused not by viruses, but by bacteria - sore throat, otitis media, and pneumonia are possible and highly probable.

— Complications of mononucleosis are usually treated with antibiotics, but there is an absolutely surprising fact that has not yet been accurately explained. The essence of this phenomenon is that the use of the deservedly popular antibiotics ampicillin and amoxicillin specifically for mononucleosis in 95% of cases is accompanied by the appearance of a rash. Let me emphasize once again, no one really knows why this is happening.

- After an acute period of illness, when all the main symptoms disappear, the child remains very weakened - time is needed for the complete restoration of the immune system. For such a child, vaccinations are stopped for 6-12 months, and contact with people should be limited as much as possible. Exposure to the sun is contraindicated, and in general any long trips to the sea are undesirable.

— The treatment of mononucleosis itself is mostly symptomatic. In very severe cases, hormonal anti-inflammatory drugs are prescribed, but, as a rule, it does not come to this. And so everything is according to the “standards” of viral infections - rest, diet, fresh air, plenty of fluids, vitamins, gargle, rinse your nose, take paracetamol.

— When infectious mononucleosis is detected in a children's group, no quarantines or special disinfections are carried out. A thorough wet cleaning is more than enough.

— The mononucleosis virus, sadly enough, has oncogenic[2] activity. All this does not occur particularly often, you just need to know that if after suffering mononucleosis normal blood does not recover for a long time (meaning, atypical mononuclear cells do not disappear, and other changes may be present), then such children must be registered and be regularly examined by a hematologist[3].

[1] Read also about lymphoid tissue in the chapters “Sore throat” and “Adenoids”.

[2] Oncogenic means contributing to the occurrence of oncological (cancerous) diseases.

[3] Hematologist is a specialist in blood diseases.

published 02/25/:43

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Mononucleosis: causes, signs, course, diagnosis, how to treat

Infectious mononucleosis is one of the most common viral infections on earth: according to statistics, 80-90% of adults have antibodies to the causative agent in their blood. It is the Epstein-Barr virus, named after the virologists who discovered it in 1964. Children, adolescents and young adults are most susceptible to mononucleosis. In people over 40 years of age, it develops extremely rarely, since before this age stable immunity is formed as a result of an infection.

The virus is especially dangerous for people over 25 years of age and pregnant women (subject to primary infection), as it causes a severe course of the disease, the addition of a bacterial infection, and can cause miscarriage or stillbirth. Timely diagnosis and proper treatment significantly reduce the risk of developing such consequences.

Pathogen and routes of transmission

The cause of mononucleosis is the Epstein-Barr virus, a large DNA-containing virus, a representative of the 4th type of the herpesvirus family. It has tropism for human B lymphocytes, that is, it is able to penetrate them thanks to special receptors on the cell surface. The virus integrates its DNA into cellular genetic information, thereby distorting it and increasing the risk of mutations with the subsequent development of malignant tumors of the lymphatic system. Its role in the development of Burkitt's lymphoma, Hodgkin's lymphoma, nasopharyngeal carcinoma, liver carcinoma, salivary glands, thymus, respiratory and digestive systems has been proven.

The virus is a strand of DNA compactly packaged in a protein shell - a capsid. On the outside, the structure is surrounded by an outer shell formed from the membrane of the cell in which the viral particle was collected. All of these structures are specific antigens, since in response to their introduction the body synthesizes immune antibodies. Detection of the latter is used to diagnose the infection, its stage and monitor recovery. In total, the Epstein-Barr virus contains 4 significant antigens:

  • EBNA (Epstein-Barr nuclear antigen) - contained in the core of the virus, is an integral part of its genetic information;
  • EA (early antigen) – early antigen, viral matrix proteins;
  • VCA (Viral capsid antigen) – viral capsid proteins;
  • LMP (latent membrane protein) – viral membrane proteins.

The source of the pathogen is a person suffering from any form of infectious mononucleosis. The virus is weakly contagious and requires prolonged and close contact for transmission. In children, the airborne route of transmission predominates; contact route is also possible - through profusely salivated toys and household items. In teenagers and older people, the virus is often transmitted through kissing with saliva or sexual intercourse. Susceptibility to the pathogen is high, that is, most of those infected for the first time become ill with infectious mononucleosis. However, asymptomatic and erased forms of the disease account for more than 50%, so often a person does not know about the infection.

The Epstein-Barr virus is unstable in the external environment: it dies when dried, exposed to sunlight and any disinfectants. In the human body, it can persist for life, being integrated into the DNA of B-lymphocytes. In this regard, there is another route of transmission - blood contact; infection is possible through blood transfusion, organ transplantation, and injection drug use. The virus causes the formation of stable lifelong immunity, so repeated attacks of the disease are the reactivation of a dormant pathogen in the body, and not a new infection.

Mechanism of disease development

The Epstein-Barr virus enters the oral mucosa with saliva or its droplets and attaches to its cells - epithelial cells. From here, viral particles penetrate the salivary glands, immune cells - lymphocytes, macrophages, neutrophils and begin to actively multiply. There is a gradual accumulation of the pathogen and infection of more and more new cells. When the mass of viral particles reaches a certain value, their presence in the body activates the immune response mechanisms. A special type of immune cells - T-killers - destroy infected lymphocytes, and therefore a large amount of biological active substances and viral particles are released into the blood. Their circulation in the blood leads to an increase in body temperature and toxic damage to the liver - at this moment the first signs of the disease appear.

A special feature of the Epstein-Barr virus is its ability to accelerate the growth and reproduction of B lymphocytes - they proliferate and subsequently transform into plasma cells. The latter actively synthesize and release immunoglobulin proteins into the blood, which, in turn, causes the activation of another series of immune cells - T-suppressor cells. They produce substances designed to suppress excessive proliferation of B lymphocytes. The process of their maturation and transition to mature forms is disrupted, and therefore the number of mononuclear cells in the blood - mononuclear cells with a narrow rim of cytoplasm - sharply increases. In fact, they are immature B lymphocytes and serve as the most reliable sign of infectious mononucleosis.

The pathological process leads to an increase in the size of the lymph nodes, since it is in them that the synthesis and further growth of lymphocytes occurs. A powerful inflammatory reaction develops in the palatine tonsils, outwardly indistinguishable from a sore throat. Depending on the depth of damage to the mucous membrane, its changes vary from friability to deep ulcers and plaque. The Epstein-Barr virus suppresses the immune response due to certain proteins, the synthesis of which occurs under the influence of its DNA. On the other hand, infected mucosal epithelial cells actively release substances that initiate an inflammatory reaction. In this regard, the amount of antibodies to the virus and a specific antiviral substance, interferon, gradually increases.

Most of the viral particles are eliminated from the body, but B-lymphocytes with embedded viral DNA remain in the human body for life, which they pass on to daughter cells. The pathogen changes the amount of immunoglobulins synthesized by the lymphocyte, and therefore can lead to complications in the form of autoimmune processes and atopic reactions. Chronic mononucleosis with a relapsing course is formed as a result of an insufficient immune response in the acute phase, due to which the virus escapes aggression and remains in sufficient quantities for exacerbations of the disease.

Clinical picture

Mononucleosis occurs cyclically and certain stages can be clearly distinguished in its development. The incubation period lasts from the moment of infection to the first signs of the disease and takes on average from 20 to 50 weeks. At this time, the virus multiplies and accumulates in quantities sufficient for massive expansion. The first signs of the disease appear during the prodromal period. A person feels weakness, increased fatigue, irritability, and muscle pain. The prodrome continues for 1-2 weeks, after which the height of the disease begins. Usually a person becomes ill acutely with an increase in body temperature up to degrees C, a sore throat, and enlarged lymph nodes.

The lymph nodes of the neck, back of the head, elbow and intestines are most often affected. Their size varies from 1.5 to 5 cm; upon palpation, a person feels slight pain. The skin over the lymph nodes is not changed, they are not fused with the underlying tissues, they are mobile, and have an elastic-elastic consistency. Severe enlargement of the intestinal lymph nodes leads to pain in the abdomen, lower back and indigestion. The spleen enlarges significantly, even to the point of rupture, since it belongs to the organs of the immune system and contains a large number of lymphatic follicles. This process is manifested by severe pain in the left hypochondrium, which increases with movement and physical activity. Reversal of lymph nodes occurs slowly, within 3-4 weeks after recovery. In some cases, polyadenopathy persists for a long time, from several months to lifelong changes.

Fever during mononucleosis is one of the most common symptoms of mononucleosis. Fever lasts from several days to 4 weeks and can change repeatedly throughout the course of the disease. On average, it begins at degrees C, gradually increasing to degrees C. Despite the duration and severity of the fever, the general condition of the patients suffers little. They generally remain active, with only a decrease in appetite and increased fatigue. In some cases, patients experience such severe muscle weakness that they cannot stand on their feet. This condition rarely lasts more than 3-4 days.

Another constant sign of mononucleosis is angina-like changes in the oropharynx. The palatine tonsils increase in size so much that they can completely block the lumen of the pharynx. A white-gray coating in the form of islands or stripes often forms on their surface. It appears on days 3-7 of illness and is associated with a sore throat and a sharp rise in temperature. The nasopharyngeal tonsil also enlarges, which is associated with difficulty in nasal breathing and snoring during sleep. The back wall of the pharynx becomes granular, its mucous membrane is hyperemic and swollen. If the swelling goes down into the larynx and affects the vocal cords, then the patient experiences hoarseness.

Liver damage in mononucleosis can be asymptomatic and with severe jaundice. The liver increases in size, protrudes 2.5-3 cm from under the costal arch, is dense, sensitive to palpation. Pain in the right hypochondrium is not associated with eating, but intensifies with physical activity and walking. The patient may notice a slight yellowing of the sclera, a change in skin tone to lemon yellow. The changes do not last long and disappear without a trace in a few days.

Infectious mononucleosis in pregnant women is usually a reactivation of the Epstein-Barr virus associated with a physiological decrease in immune defense. The incidence increases towards the end of pregnancy and accounts for about 35% of the total number of expectant mothers. The disease manifests itself as fever, enlarged liver, sore throat and reaction of the lymph nodes. The virus can penetrate the placenta and infect the fetus, which occurs when its concentration in the blood is high. Despite this, infection in the fetus rarely develops and is usually represented by pathologies of the eyes, heart, and nervous system.

A rash with mononucleosis appears on average on the 5-10th day of illness and in 80% of cases is associated with taking the antibacterial drug ampicillin. It is maculopapular in nature, its elements are bright red, located on the skin of the face, torso and limbs. The rash remains on the skin for about a week, after which it turns pale and disappears without a trace.

Mononucleosis in children is often asymptomatic or with a mild clinical picture in the form of ARVI. The disease is dangerous for babies with congenital immunodeficiency or atopic reactions. In the first case, the virus aggravates the lack of immune defense and promotes the addition of a bacterial infection. In the second, it enhances the manifestations of diathesis, initiates the formation of autoimmune antibodies and can become a provoking factor for the development of tumors of the immune system.

Classification

Infectious mononucleosis is divided according to severity into:

  1. Mild – intoxication is absent or lasts no more than 5 days. The temperature does not exceed 38 degrees C and lasts no more than 5 days. Sore throat is catarrhal in nature, with possible isolated islands of plaque on the tonsils, lasting no more than 3 days. Only the cervical lymph nodes are enlarged, their size does not exceed 1.5 cm. The liver protrudes from under the costal arch no more than 1.5 cm. Recovery occurs within 2 weeks.
  2. Moderate – intoxication is moderate and lasts up to one week. Body temperature reaches 38.5 degrees C and lasts up to 8 days. The palatine tonsils are enlarged, but do not completely cover the pharynx. On their surface there is a white-gray coating in the form of stripes; sore throat lasts no more than 6 days. The cervical lymph nodes are enlarged in a chain; the intra-abdominal lymph nodes are involved in the process. Their size does not exceed 2.5 cm. The liver protrudes from under the costal arch by no more than 2.5 cm. Complications occur, complete recovery occurs in 3-4 weeks.
  3. Severe – intoxication is severe and lasts more than 8 days. Body temperature reaches values ​​above 39.5 degrees C and persists for more than 9 days. Sore throat is necrotic in nature - ulcers and whitish films form on the surface of the tonsils. The tonsils are significantly increased in size and completely block the lumen of the pharynx. The size of the lymph nodes exceeds 2.5 cm; they are palpated under the skin in packets - in groups of several pieces. The liver protrudes from under the costal arch by more than 3 cm. Complications are sure to occur; the disease lasts at least 4 weeks.

By type, infectious mononucleosis is divided into:

  • Typical - characterized by a cyclical course, angina-like changes, enlarged lymph nodes, liver damage and characteristic changes in the blood picture.
  • Atypical - combines the asymptomatic course of the disease, its erased form, usually taken for ARVI, and the most severe form - visceral. The latter occurs with the involvement of many internal organs and leads to serious complications.

According to the duration of the course, infectious mononucleosis can be:

  1. Acute – manifestations of the disease last no more than 3 months;
  2. Prolonged – changes persist from 3 to 6 months;
  3. Chronic – lasts more than six months. This same form of the disease includes repeated fever, malaise, and enlarged lymph nodes within 6 months after recovery.

Relapse of infectious mononucleosis is the re-development of its symptoms a month after recovery.

Diagnostics

The diagnosis and treatment of infectious mononucleosis is carried out by an infectious disease specialist. It is based on:

  • Typical complaints include prolonged fever, sore throat-like changes in the oropharynx, enlarged lymph nodes;
  • Epidemiological history - household or sexual contact with a person who had a fever for a long time, blood transfusion or organ transplantation 6 months before the disease;
  • Examination data - hyperemia of the pharynx, plaque on the tonsils, enlargement of the lymph nodes, liver and spleen;
  • The results of laboratory tests - the main sign of damage by the Epstein-Barr virus is the appearance in the venous or capillary blood of a large number (more than 10% of the total number of leukocytes) of mononuclear cells. It is from this that the disease got its name - mononucleosis, and before the advent of methods for detecting the pathogen, it was its main diagnostic criterion.

Today, more accurate diagnostic methods have been developed that make it possible to establish a diagnosis even if the clinical picture is not typical for damage by the Epstein-Barr virus. These include:

  1. PCR diagnostics – isolation of pathogen DNA from saliva, lymph node biopsy, human blood;
  2. ELISA diagnostics is the detection of specific antiviral antibodies in the patient’s blood.

Based on the ratio of antibodies to various proteins of the virus, the doctor can determine the period of the disease, determine whether there was an initial encounter with the pathogen, a relapse or reactivation of the infection:

  • The acute period of mononucleosis is characterized by the appearance of IgMk VCA (from the first days of the clinic, persists for 4-6 weeks), IgG to EA (from the first days of the disease, persists throughout life in small quantities), IgG to VCA (appears after IgMVCA, persists for life) .
  • Recovery is characterized by the absence of IgMk VCA, the appearance of IgG to EBNA, a gradual decrease in the level of IgG to EA and IgG to VCA.

Also, a reliable sign of acute or reactivation of infection is high (more than 60%) avidity (affinity) of IgG for the Epstein-Barr virus.

In a general blood test, leukocytosis is observed with an increase in the proportion of lymphocytes and monocytes to 80-90% of the total number of leukocytes, and an acceleration of ESR. Changes in the biochemical blood test indicate damage to liver cells - the level of ALT, AST, GGTP and alkaline phosphatase increases, the concentration of indirect bilirubin may increase in jaundice. An increase in the concentration of total plasma protein is associated with excess production of a number of immunoglobulins by mononuclear cells.

Various imaging methods (ultrasound, CT, MRI, X-ray) allow you to assess the condition of the lymph nodes of the abdominal cavity, liver, and spleen.

Treatment

Treatment of mononucleosis is carried out on an outpatient basis for mild cases of the disease; patients with moderate and severe forms are hospitalized in an infectious diseases hospital. Hospitalization is also carried out for epidemiological reasons, regardless of the severity of the disease. These include living in crowded conditions - a dormitory, barracks, orphanage and boarding schools. To date, there are no drugs that can act directly on the cause of the disease - the Epstein-Barr virus - and remove it from the body, so therapy is aimed at alleviating the patient’s condition, maintaining the body’s defenses and preventing negative consequences.

During the acute period of mononucleosis, patients are advised to rest, bed rest, plenty of warm drinks in the form of fruit drink, weak tea, compote, and an easily digestible diet. To prevent bacterial complications, it is necessary to rinse the pharynx 3-4 times a day with antiseptic solutions - chlorhexidine, furacillin, chamomile decoction. Physiotherapy methods - ultraviolet irradiation, magnetic therapy, UHF are not carried out, as they cause additional activation of the cellular component of immunity. They can be used after the size of the lymph nodes has normalized.

Among the medications prescribed:

  1. Antiviral agents - act nonspecifically, increase the production of their own antiviral interferon (cycloferon, tiloron). Contraindicated for pregnant women;
  2. Human interferon alpha - is administered to strengthen the body's immune defense;
  3. Antipyretics (NSAIDs) – normalize body temperature (ibuprofen, nimesulide);
  4. Antibiotics – used for severe and moderate forms of the disease to prevent bacterial complications (ceftriaxone, azithromycin);
  5. Glucocorticoids – suppress the proliferation of immune cells, reduce body temperature (prednisolone, dexamethasone);
  6. Solutions for intravenous administration - have a detoxifying effect, alleviate the course of the disease (saline solution, dextrose);
  7. Antifungal agents – in case of development of fungal complications (fluconazole, nystatin).

Treatment of pregnant women is aimed at eliminating symptoms and is carried out with drugs that are safe for the fetus:

  • Human interferon in the form of rectal suppositories;
  • Folic acid;
  • Vitamins E, group B;
  • Troxevasin capsules;
  • Calcium preparations – calcium orotate, calcium pantothenate.

The average duration of treatment is days. After suffering from infectious mononucleosis, a person must be monitored by a local physician for 12 months. Every 3 months, laboratory monitoring is carried out, which includes a general and biochemical blood test, and, if necessary, determination of antibodies to the Epstein-Barr virus in the blood.

Complications of the disease

Rarely develop, but can be extremely severe:

  1. Autoimmune hemolytic anemia;
  2. Meningoencephalitis;
  3. Guillain-Barre syndrome;
  4. Psychosis;
  5. Damage to the peripheral nervous system – polyneuritis, cranial nerve palsy, paresis of facial muscles;
  6. Myocarditis;
  7. Rupture of the spleen (usually found in a child).

Specific prevention (vaccination) has not been developed, therefore, to prevent infection, general strengthening measures are carried out: hardening, walks in the fresh air and ventilation, varied and proper nutrition. It is important to promptly and fully treat an acute infection, as this will reduce the risk of chronicity of the process and the development of severe complications.

Source: http://uhonos.ru/infekcii/mononukleoz/

Infectious mononucleosis

General information

Infectious mononucleosis - what is it?

This article is about what kind of disease this is, how it progresses and is treated. Mononucleosis is an acute viral disorder (ICD 10 code: B27), which is accompanied by an enlarged spleen and liver, disruption of the reticuloendothelial system, changes in leukocytes and lymphadenopathy.

What kind of disease is mononucleosis, as Wikipedia points out, was first told to the world in 1885 by the Russian scientist N.F. Filatov and initially called it idiopathic lymphadenitis. It is currently known that it is caused by the herpes virus type 4 (Epstein-Barr virus), which affects lymphoid tissue.

How is mononucleosis transmitted?

Most relatives and the sick themselves often have questions: “How contagious is mononucleosis, is it contagious at all, and how can you get infected?” The infection is transmitted by airborne droplets, initially attaches to the epithelium of the oropharynx, and then enters the regional lymph nodes after transit through the bloodstream. The virus remains in the body throughout life, and when natural defenses are reduced, the disease can recur.

What is infectious mononucleosis and how it is treated in adults and children can be found out in more detail after reading this article in full.

Is it possible to get mononucleosis again?

One of the frequently asked questions is “Can mononucleosis infection recur?” It is impossible to become infected with mononucleosis again, since after the first encounter with the infection (it does not matter whether the disease has occurred or not), a person becomes its carrier for life.

Causes of infectious mononucleosis in children

Children under 10 years of age are most susceptible to this disease. The Epstein-Barr virus circulates most often in closed communities (kindergarten, school), where infection occurs through airborne droplets. When released into an open environment, the virus quickly dies, so infection occurs only with sufficiently close contact. The causative agent of mononucleosis is detected in the saliva of a sick person, so it can also be transmitted by sneezing, coughing, kissing, or using shared utensils.

Infectious mononucleosis in children, photo

It is worth mentioning that this infection is registered 2 times more often in boys than in girls. Some patients with viral mononucleosis are asymptomatic, but are carriers of the virus and are potentially dangerous to the health of others. They can only be identified by conducting a special test for mononucleosis.

Viral particles enter the bloodstream through the respiratory tract. The incubation period has an average duration of 5-15 days. In some cases, as reported by the Internet forum and some patients, it can last up to one and a half months (the reasons for this phenomenon are unknown). Mononucleosis is a fairly common disease: before the age of 5, more than half of children become infected with the Epstein-Barr virus, but in most it occurs without serious symptoms or manifestation of the disease. Infection among the adult population varies in different populations within the range of 85-90%, and only in some patients this virus manifests itself with symptoms on the basis of which a diagnosis of infectious mononucleosis is made. The following special forms of the disease may occur:

  • atypical mononucleosis - its symptoms in children and adults are associated with a stronger severity of symptoms than usual (for example, the temperature can rise to 39.5 degrees or the disease can occur without fever at all); diet should be a mandatory component of treatment for this form due to the fact that atypical mononucleosis tends to cause severe complications and consequences in children;
  • chronic mononucleosis, described in the section of the same name, is considered as a consequence of the deterioration of the patient’s immune system.

Parents often have questions about how long the temperature lasts during the infection described. The duration of this symptom can vary significantly depending on individual characteristics: from several days to one and a half months. In this case, the question of whether to take antibiotics for hyperthermia or not should be decided by the attending physician.

Also a fairly common question: “should I take Acyclovir or not?” Acyclovir is included in many officially approved treatment regimens, but recent studies prove that such treatment does not affect the course of the disease and does not in any way improve the condition of the patient.

Treatment and symptoms in children (how to treat mononucleosis and how to treat it in children) are also described in detail in the program by E.O. Komarovsky "Infectious mononucleosis". Video from Komarovsky:

Mononucleosis in adults

This disease rarely develops in people over 35 years of age. But atypical signs of the disease and chronic mononucleosis, which have potentially dangerous consequences, on the contrary, are more common in percentage terms.

Treatment and symptoms in adults are not fundamentally different from those in children. More details about what to treat and how to treat it in adults are described below.

Infectious mononucleosis, symptoms

Symptoms of mononucleosis in children

To date, methods for specific prevention against infection with the described virus have not been developed, so if the child was unable to avoid contact with the infected person, parents need to carefully monitor the child’s condition over the next 3 months. If no signs of the disease appear within the specified period, it can be argued that either the infection did not occur, or the immune system suppressed the virus and the infection was asymptomatic. If signs of general intoxication appear (fever, chills, rash, weakness, enlarged lymph nodes), then you should immediately contact a pediatrician or infectious disease specialist (about which doctor treats mononucleosis).

Symptoms of Epstein-Barr virus in children at the initial stage of the disease include general malaise, catarrhal symptoms and weakness. Then there is a sore throat, low-grade fever, redness and swelling of the mucous membranes of the oropharynx, nasal congestion, and enlarged tonsils. In some cases, a fulminant form of infection occurs, when symptoms appear suddenly and their severity quickly intensifies (drowsiness, fever up to 39 degrees for several days, chills, increased sweating, weakness, muscle and throat pain, headache). Next comes the period of the main clinical manifestations of infectious mononucleosis, in which the following is observed:

Rash due to mononucleosis, photo

The rash with mononucleosis usually appears in the initial period of the disease, simultaneously with lymphadenopathy and fever, and is located on the arms, face, legs, back and abdomen in the form of small reddish spots. This phenomenon is not accompanied by itching and does not require treatment; it goes away on its own as the patient recovers. If the rash begins to itch in a patient taking antibiotics, this may indicate the development of an allergy, since with mononucleosis the skin rash does not itch.

The most important symptom of the described infection is polyadenitis, which occurs due to hyperplasia of the lymph node tissue. Often islands of light plaque appear on the tonsils, which are easily removed. Peripheral lymph nodes are also enlarged, especially the cervical ones. When you turn your head to the side, they become quite noticeable. Palpation of the lymph nodes is sensitive but not painful. Less commonly, the abdominal lymph nodes enlarge and, squeezing the regional nerves, they provoke the development of the “acute abdomen” symptom complex. This phenomenon can lead to an incorrect diagnosis and diagnostic laparotomy.

Symptoms of mononucleosis in adults

Viral mononucleosis practically does not occur in older people, since this subpopulation, as a rule, already has a developed immunity to the causative agent of the disease. Symptoms of the Epstein-Barr virus in adults, if the disease does develop, are no different from those in children.

Hepatosplenomegaly in children and adults

As mentioned above, the described disease is characterized by hepatosplenomegaly. The liver and spleen are extremely sensitive to the virus; as a result, enlargement of the liver and spleen in children and adults is observed already in the first days of the disease. In general, the causes of hepatosplenomegaly in children and adults include a variety of viral, oncological diseases, as well as blood diseases and systemic lupus erythematosus, so in this situation a comprehensive examination is necessary.

Symptoms of a diseased spleen in humans:

  • an increase in the size of the organ, which can be detected by palpation and ultrasound;
  • soreness, feeling of heaviness and discomfort in the left abdomen.

Disease of the spleen provokes its enlargement so much that the parenchyma of the organ is able to rupture its own capsule. During the first few days, there is a continuous increase in the size of the liver and spleen, and when the body temperature returns to normal, their size returns to normal levels.

Symptoms of splenic rupture in adults and children, based on analysis of patient records:

  • darkening of the eyes;
  • nausea and vomiting;
  • flashes of light;
  • weakness;
  • dizziness;
  • increasing diffuse abdominal pain.

How to treat the spleen?

If the spleen is enlarged, restriction of physical activity and bed rest are indicated. If an organ rupture is nevertheless diagnosed, then its urgent removal is necessary.

Chronic mononucleosis

Prolonged persistence of the virus in the body is rarely asymptomatic. Considering that with a latent viral infection, a wide variety of diseases can appear, it is necessary to clearly identify the criteria for diagnosing chronic viral mononucleosis.

Symptoms of the chronic form:

  • a severe form of primary infectious mononucleosis suffered within six months or associated with high titers of antibodies to the Epstein-Barr virus;
  • an increase in the content of virus particles in the affected tissues, confirmed by anti-complementary immunofluorescence with the pathogen antigen;
  • damage to some organs confirmed by histological studies (splenomegaly, interstitial pneumonia, uveitis, bone marrow hypoplasia, persistent hepatitis, lymphadenopathy).

Diagnosis of the disease

To confirm mononucleosis, the following studies are usually prescribed:

The main symptoms of the disease on the basis of which the diagnosis is made are enlarged lymph nodes, tonsillitis, hepatosplenomegaly, and fever. Hematological changes are a secondary sign of the disease. The blood picture is characterized by an increase in ESR, the appearance of atypical mononuclear cells and wide-plasma lymphocytes. However, it should be borne in mind that these cells can appear in the blood only 3 weeks after infection.

Broad plasma lymphocytes and atypical mononuclear cells

Mononuclear cells and wide-plasma lymphocytes - what are they and are they the same thing?

Broad plasma lymphocytes in a child, photo

These concepts are often equated, but from the point of view of cell morphology there are significant differences between them.

Broad-plasma lymphocytes are cells with large cytoplasm and a dense nucleus that appear in the blood during viral infections.

Mononuclear cells in a general blood test appear mainly in viral mononucleosis. Atypical mononuclear cells in the blood are large cells with a separated cytoplasm and a large nucleus containing small nucleoli.

Mononuclear cells in the blood of a child, photo

Thus, a specific sign for the described disease is only the appearance of atypical mononuclear cells, and wide-plasma lymphocytes may not be present with it. It is also worth remembering that mononuclear cells can be a symptom of other viral diseases.

Additional laboratory diagnostics

To make the most accurate diagnosis in difficult cases, a more accurate test for mononucleosis is used: the titer of antibodies to the Epstein-Barr virus is studied or a PCR (polymerase chain reaction) test is prescribed. Deciphering a blood test for mononucleosis and a general analysis (in children or adults has similar assessment parameters) of blood with the indicated relative amount of atypical mononuclear cells makes it possible to confirm or refute the diagnosis with a high degree of probability.

Also, patients with mononucleosis are prescribed a series of serological tests to detect HIV infection (blood test for HIV), since it can provoke an increase in the concentration of mononuclear cells in the blood. If symptoms of tonsillitis are detected, it is recommended to visit an ENT doctor and perform a pharyngoscopy to determine the etiology of the disorder.

How can adults and other children not get infected from a sick child?

If there is a family member infected with viral mononucleosis, it will be difficult not to infect other family members due to the fact that after complete recovery the patient continues to periodically release the virus into the environment and remains its carrier for the rest of his life. Therefore, there is no need to quarantine the patient: if other family members do not become infected during the period of the relative’s illness, it is highly likely that infection will occur later.

Infectious mononucleosis, treatment

How to treat and how to treat Epstein-Barr virus in adults and children?

Treatment of infectious mononucleosis in children, as well as symptoms and treatment of Epstein-Barr virus in adults, are not fundamentally different. The approaches and drugs used for therapy are in most cases identical.

Symptoms of Epstein-Barr virus

There is no specific treatment for the described disease, nor is there a general treatment regimen or antiviral drug that could effectively fight the virus. As a rule, the disease is treated on an outpatient basis; in severe clinical cases, the patient is placed in a hospital and prescribed bed rest.

Indications for hospitalization include:

Treatment of mononucleosis is carried out in the following areas:

  • prescription of antipyretic drugs (Paracetamol or Ibuprofen are used for children);
  • the use of local antiseptic drugs for the treatment of mononucleosis sore throat;
  • local nonspecific immunotherapy with IRS 19 and Imudon;
  • prescription of desensitizing agents;
  • vitamin therapy;
  • if liver damage is detected, choleretic drugs and hepatoprotectors are recommended, and a special diet is prescribed (therapeutic table-diet No. 5);
  • it is possible to prescribe immunomodulators (Viferon, Anaferon, Imudon, Cycloferon) together with antiviral drugs to obtain the greatest effect;
  • antibiotics for mononucleosis (Metronidazole tablets) are prescribed to prevent the development of microbial complications in the presence of intense inflammation of the oropharynx (penicillin antibiotics for infectious mononucleosis are not prescribed due to the high likelihood of severe allergies);
  • while taking antibiotics, probiotics are used together (Narine, Acipol, Primadofilus);
  • in case of development of a severe hypertoxic form of the disease with a risk of asphyxia, a 7-day course of Prednisolone is indicated;
  • in case of severe swelling of the larynx and the development of breathing difficulties, it is recommended to perform a tracheostomy and transfer the patient to artificial ventilation;
  • if a splenic rupture is diagnosed, splenectomy is performed on an emergency basis (the consequences of a splenic rupture without qualified assistance can be fatal).

Prognosis and consequences of mononucleosis

Patients who have recovered from viral mononucleosis are usually given a favorable prognosis.

Timely prediction of mononucleosis

It is worth noting that the main condition for the absence of complications and adverse consequences is the timely detection of leukemia and constant monitoring of changes in blood parameters. It is also extremely important to monitor the well-being of patients until they fully recover. Scientific research revealed:

  • body temperature above 37.5 degrees persists for approximately several weeks;
  • symptoms of sore throat and sore throat persist for 1-2 weeks;
  • the condition of the lymph nodes is normalized within 4 weeks from the moment of manifestation of the disease;
  • Complaints of drowsiness, fatigue, weakness can be detected for another 6 months.

Adults and children who have recovered from the disease need regular medical examinations for six months to a year, with mandatory regular blood tests.

Complications are generally rare. The most common consequences are hepatitis, yellowing of the skin and darkening of urine, and the most serious consequence of mononucleosis is rupture of the membrane of the spleen, which occurs due to thrombocytopenia and overstretching of the organ capsule and requires emergency surgical intervention. Other complications are associated with the development of secondary streptococcal or staphylococcal infection, the development of meningoencephalitis, asphyxia, severe forms of hepatitis and interstitial bilateral infiltration of the lungs.

Effective and specific prevention of the described disorder has not currently been developed.

Risks during pregnancy

The disease poses a serious danger during pregnancy. The Epstein-Barr virus can increase the risk of premature abortion, provoke fetal malnutrition, and also cause hepatopathy, respiratory distress syndrome, recurrent chroniosepsis, changes in the nervous system and visual organs.

When infected with a virus during pregnancy, there is a very high probability of infection of the fetus, which may subsequently be the root cause of lymphadenopathy, prolonged low-grade fever, chronic fatigue syndrome and hepatosplenomegaly in the child.

Education: Graduated from Vitebsk State Medical University with a degree in Surgery. At the university he headed the Council of the Student Scientific Society. Advanced training in 2010 - in the specialty "Oncology" and in 2011 - in the specialty "Mammology, visual forms of oncology".

Work experience: Worked in a general medical network for 3 years as a surgeon (Vitebsk Emergency Hospital, Liozno Central District Hospital) and part-time as a district oncologist and traumatologist. Worked as a pharmaceutical representative for a year at the Rubicon company.

Presented 3 rationalization proposals on the topic “Optimization of antibiotic therapy depending on the species composition of microflora”, 2 works took prizes in the republican competition-review of student scientific works (categories 1 and 3).

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Source: http://medside.ru/infektsionnyiy-mononukleoz