Mononucleosis symptoms and treatment in children

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Infectious mononucleosis in a child: symptoms and treatment

Many mothers are very surprised when their baby with seemingly ordinary cold symptoms is diagnosed by a pediatrician with infectious mononucleosis. In fact, this disease, caused by the Epstein-Barr virus, is one of the most common in the world.

Table of contents:

It is important for parents to understand the difference between infectious mononucleosis and other common viral and cold diseases. The timeliness and effectiveness of treatment, and sometimes even the health and life of the child, depend on this.

What is infectious mononucleosis

Infectious mononucleosis has many names. Parents may be given a diagnosis for their child such as Filatov’s disease or monocytic tonsillitis. But the most terrible thing seems to be benign lymphoblastosis. But this is all one type of viral infection of the oropharynx and lymph nodes. Infectious mononucleosis affects the liver and spleen; under the influence of the virus, a change in blood composition occurs.

For the first time, the disease, which is now called mononucleosis, was described by the scientist N.F. Filatov and called it idiopathic lymphadenitis. The disease was and is now an infectious viral disease, occurring in an acute form with its characteristic enlargement of the liver, spleen, disorder of the reticuloendoyelial system, changes in white blood and complicated by lymphadenopathy.

Epstein-Barr virus is one of the types of herpes infection. Therefore, 98% of people on the entire planet have antibodies to it in their bodies. But due to the erased symptoms, similar to ARVI, sore throat and inflammation of the adenoids, a person may never know that he once had mononucleosis. But in rare cases, this disease occurs in an acute form with serious complications and consequences.

The Epstein-Barr virus enters the human body through airborne droplets and first affects the epithelium and mucous membranes of the nasopharynx, and then spreads throughout the body through the bloodstream, thereby striking the lymph nodes. The insidiousness of the virus is that it is completely impossible to get rid of it; it remains in the human body forever and whenever the immune system weakens, it makes itself felt.

How is mononucleosis transmitted?

Infectious mononucleosis occurs from a sick person during the acute period, and the symptoms may be minor. Main routes of transmission:

  • close contacts with virus carriers (hugs, kisses);
  • during blood transfusion;
  • with large crowds of people (public transport, markets);
  • through other people's hygiene products.

Mononucleosis often develops in children with weakened immune systems, after severe emotional or physical stress. Before 5 years of age, 50% of children become infected with this type of human herpes virus, but not all of them experience inflammation of the oropharynx and lymph nodes. They become lifelong carriers of the Epstein-Barr virus. Adolescent children are also at risk. It is during this period of life that the child’s body is most vulnerable. It is noteworthy that girls suffer from infectious mononucleosis at the age of 16-17, and boys a little later. After the first infection, symptoms of the disease appear within 6-21 days. This variation is explained by the unstable incubation period of the virus.

A high probability of contracting the Epstein-Barr virus remains among children under 10 years of age. The virus feels great and spreads in children's groups, for example, kindergartens, schools, and health camps. However, it dies very quickly throughout the human body, and infection is possible only through very close contact with the carrier.

Causes of infectious mononucleosis in children

The airborne transmission of the Epstein-Barr virus allows mononucleosis to spread easily and quickly. A person who has had the disease sheds the virus in their saliva for another 18 months. He becomes a potential transmitter of infection to surrounding people. The rapid spread of infection occurs in autumn and winter due to cold weather conditions. In the spring, there is also an increase in infectious mononucleosis. After a long winter, the human body suffers from a lack of vitamins and sunlight and is unable to fully defend itself against external attacks.

The presence of the virus in a sick child or adult is concentrated in the saliva, so you can become infected by coughing, sneezing, sharing utensils with a carrier of the infection, or by kissing. When infected, the virus can manifest itself literally in a matter of days, and sometimes a person does not even know for several weeks that he has become a carrier of the infection. The incubation period of the Epstein-Barr virus ranges from 5 to 15 days, and sometimes this period can extend up to 6 weeks. The minimum incubation period is 2 days for a very weakened body.

Main symptoms of mononucleosis

In the first days, mononucleosis is manifested by general weakness and inflammation of the mucous membranes of the upper respiratory tract. Over time, the child’s well-being deteriorates significantly, he develops a runny nose, a sore throat, and his body temperature rises significantly. Most often, parents assume that the child has a common cold or a viral infection of ARVI and treat their child with proven folk recipes and remedies.

Characteristic signs of infectious mononucleosis are hyperemia of the nasopharynx and proliferation of the tonsils. In rare cases, the disease occurs with pronounced symptoms. In this case, the child suddenly develops the following symptoms:

  • a sharp jump in body temperature up to 40°C;
  • increased sweating;
  • chills;
  • drowsiness;
  • headache;
  • muscle pain.

Parents panic when, with acute infectious mononucleosis, their child is unable to get up in bed and simply go to the toilet to relieve himself.

Secondary symptoms of mononucleosis

Over time, the clinical picture of infectious mononucleosis becomes clearer. In a child, the lymph nodes in the groin, neck, corners of the lower jaw and under the armpits become inflamed and significantly increase in size. It is in them that the virus settles in order to quickly reproduce. Abdominal pain can be caused by enlarged lymph nodes in the abdominal cavity.

With infectious mononucleosis, skin rashes are also common. Small red spots can be localized on any part of the body - face, back, stomach. The rash does not cause discomfort and does not require special treatment. At the same time, a gray or yellow coating forms on the tonsils of the nasopharynx and palate. This loose substance does not bother the child and can be easily removed if necessary.

Under the influence of the Epstein-Barr virus, the liver and spleen increase in size, they are excessively sensitive to pathogenic microorganisms. It is very important to monitor the condition of these organs for 1-2 months. Even after the child recovers, their pathological growth may continue, which increases the risk of developing serious life-threatening complications. Enlargement of the spleen is especially dangerous; it can acquire dimensions at which its tissues cannot withstand the pressure and rupture.

So, secondary signs of infectious mononucleosis are:

  • clinical manifestation of angina;
  • swollen lymph nodes;
  • the appearance of a rash on the skin;
  • an increase in the size of the liver and spleen;
  • severe intoxication of the body.

The child literally cannot get out of bed to go to the toilet.

Diagnosis of infectious mononucleosis in children

Parents are unlikely to be able to identify infectious mononucleosis on their own. Its clinical picture in the first days is very similar to other viral, bacterial and even parasitic infections, which significantly triggers the course of the disease, because mistaking it for a cold, parents are in no hurry to call a doctor.

Pediatricians also do not make this diagnosis without confirmation from an infectious disease specialist. To accurately diagnose mononucleosis, laboratory tests are necessary:

  1. A complete blood count shows an increase in leukocytes.
  2. An enzyme immunoassay determines the presence or absence of antibodies to the Epstein-Barr virus.
  3. Polymerase chain reaction is a method that allows you to determine the causative agent of an infectious disease at the DNA level.

Diagnostic centers also conduct a special test for mononucleosis. When studying biological material, atypical mononuclear cells are found that damage white blood cells. These peculiar lymphocytes appear during the initial infection and remain in the blood for up to 4 months after recovery.

Treatment of infectious mononucleosis in children

Modern pharmacology has not yet been able to create an effective drug for infectious mononucleosis. Conventional antiviral drugs cannot suppress the activity of this virus. In mild forms, mononucleosis can be treated at home. But for severe symptoms, hospitalization is indicated:

  • body temperature does not drop above 39.5°C;
  • severe intoxication of the body;
  • complication in the form of threat of asphyxia.

Therapy consists of eliminating the symptoms of intoxication of the body from the vital activity of the virus. Ibuprofen or paracetamol syrup are used to reduce body temperature in children. During the period of illness, it is important to take vitamins C, B and P. If pathological changes occur in the liver, then a gentle diet and choleretic drugs are prescribed. In order to increase immune defense, it is justified to take immunomodulators - Anaferon, Viferon and Cycloferon.

Antibiotics are prescribed only in case of complications and severe inflammation of the oropharynx. In this case, penicillin antibiotics should not be used. In most cases of mononucleosis, they cause a severe allergic reaction with an increased risk of anaphylactic shock. Antibiotic treatment should be accompanied by probiotics to maintain normal microflora in the gastrointestinal tract.

In case of excessive toxic damage, leading to difficulty breathing and the risk of asphyxia, prednisolone is used in a hospital setting. In severe cases, doctors have to perform a tracheotomy, a surgical procedure to insert a tube into the trachea. If the larynx is severely swollen, the child is transferred to a ventilator. A complication such as splenic rupture requires emergency surgery to remove the organ.

In children, the course of infectious mononucleosis in most cases occurs without serious complications. But parents must remember that a favorable outcome of the disease depends on timely diagnosis and constant monitoring of the condition of the liver and spleen and blood composition. In case of mononucleosis, it is important to monitor the child’s condition until complete recovery.

Preventive actions

The golden rule of any doctor sounds something like this: “It is easier to prevent a disease than to treat it.” And infectious mononucleosis is no exception. But how to prevent the virus from entering the body, since you cannot be sure that no one from the child’s immediate environment or passers-by are carriers of this virus?

The main and basic rule that will help protect your child from infection is increasing immunity. The child should lead a healthy lifestyle, eat well and properly, get all the necessary vitamins and minerals in the diet, spend more time in the fresh air and observe the rules of personal hygiene.

If someone in the family is sick with mononucleosis, there is no point in quarantining the child, because the infection could have entered his body a long time ago and is now waiting for the very moment when the child’s immune system fails. Unfortunately, there are no other ways to protect against infectious mononucleosis.

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One comment

Unfortunately, not all diseases can be cured with folk remedies such as milk and honey. At first we thought it was a common ARVI, we treated it with folk remedies, but in the end it turned out that it was mononucleosis. The temperature lasted for a whole week, the pediatrician prescribed Ixim Lupine. She said that it does not cause an itchy rash. The active ingredient is cefixime, I googled it and it says that it is a third generation antibiotic, it is more effective than usual, and has fewer side effects. We started drinking, two days later my daughter felt better, her temperature finally began to subside. After three, I had strength and a smile on my face. We are rapidly improving! I really didn’t notice any side effects. I recommend it.

Source: http://childage.ru/zdorove/bolezni-u-detej/infektsionnyiy-mononukleoz-u-rebenka-simptomyi-i-lechenie.html

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.

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/

How and with what to treat infectious mononucleosis in children and for how long? Characteristic symptoms and selection of treatment methods

Infectious mononucleosis was first described by N. Filatov at the end of the 19th century. The disease is called idiopathic lymphadenitis. This is an acute viral infection characterized by changes in lymph, enlargement of the liver and spleen, and hyperemia of the throat. The disease is caused by Epstein-Barr virus type 4, which destroys lymphoid-reticular tissue.

Infectious mononucleosis often occurs in children, especially under 10 years of age. Boys are twice as likely to be exposed to it than girls. Most people on the planet suffer from mononucleosis, but 80% of patients have mild symptoms or are asymptomatic. Symptoms are especially pronounced in weakened children with low immunity.

Causes of development and routes of infection

Children after 3-5 years of age usually stay in closed groups of a kindergarten or school, so the greatest likelihood of contracting mononucleosis is there. The virus is transmitted by airborne droplets or household contact through close contact between a carrier and a healthy person. In the environment, the pathogen dies very quickly. In a sick child, it remains in the saliva for another 6 months after recovery and can be transmitted by:

Sometimes the virus is transmitted when blood contaminated by it is transfused into a healthy person. It is difficult to diagnose mononucleosis in children under 10 years of age, since it has a blurred clinical picture and passes quickly. In adolescents and adults, the course of the disease can last for months. If a child has been ill once, he or she develops lifelong immunity, but the Epstein-Barr virus remains in the body.

Characteristic signs and symptoms

Today there is no prevention against viral infection, so it is necessary to pay attention to symptoms that may indicate that a child is infected. In infectious mononucleosis they can be varied. The disease can be practically asymptomatic or have a pronounced clinical picture.

From the moment the virus enters the body until the first manifestations of the disease can pass from 1 week to several months. The child develops general weakness and malaise. As the disease progresses, the patient's well-being becomes worse. The temperature rises to low-grade levels, a sore throat and nasal congestion appear. Mononucleosis is characterized by redness of the throat mucosa and enlargement of the tonsils.

With a pronounced course of the disease, there may be a fever that lasts several days. In addition, the patient experiences the following symptoms:

  • excessive sweating;
  • headache;
  • pain when swallowing;
  • drowsiness;
  • muscle aches.

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After this, specific symptoms of infectious mononucleosis increase:

  • hyperemia of the posterior wall of the throat mucosa, its hemorrhage;
  • enlargement of peripheral lymph nodes;
  • general intoxication;
  • enlarged spleen and liver;
  • rash on the body.

Rashes may appear at the beginning of the infectious process along with fever. They look like pale pink or red spots, which are localized on different parts of the body (face, stomach, limbs, back). The rash does not require treatment. It does not cause itching and goes away gradually on its own.

A distinctive sign of mononucleosis is polyadenitis due to hyperplasia of lymphoid tissue. Grayish or yellow-white lumpy deposits form on the tonsils. They have a loose structure and can be easily removed.

The child experiences enlargement of the cervical lymph nodes (sometimes up to 3 cm). They become a barrier to the active virus. The lymph nodes in the back of the neck are especially noticeably enlarged. In most cases, lymph node involvement is bilateral. There is practically no pain on palpation. Rarely there is an enlargement of the lymph nodes in the abdominal cavity, in which the child may experience signs of an acute abdomen.

The liver and spleen are very sensitive to the Epstein-Barr virus. Therefore, changes occur in them immediately after infection of the body. Over the course of about 2-4 weeks, these organs continuously increase in size. After which they gradually return to their normal physiological position.

Diagnostics

Since the symptoms of infectious mononucleosis are very vague, it is necessary to undergo several tests to confirm the diagnosis:

  • general and biochemical blood test;
  • blood to determine the titer of antibodies to the Epstein-Barr virus;
  • PCR;
  • Ultrasound of internal organs.

Based on external signs, it is difficult for a doctor to differentiate between tonsillitis and mononucleosis. Therefore, serological studies are carried out. A complete blood count may show elevated levels of leukocytes, lymphocytes and monocytes. With mononucleosis, the content of atypical mononuclear cells in the blood increases. But they appear only 2-3 weeks after the virus enters the body. Also, when making a diagnosis, it is necessary to exclude diseases such as diphtheria, leukemia, Botkin's disease.

Methods and rules of treatment

There is no specific treatment for infectious mononucleosis in children. The doctor prescribes only symptomatic treatment to alleviate the child’s condition. During the first 2 weeks you need to adhere to bed rest. Antibiotics are not effective for viral infections (only for secondary infections). In addition, they reduce already weakened immunity.

Drug therapy

At high temperatures, taking antipyretic drugs is indicated:

To treat the throat, antiseptic local remedies are used, as for a sore throat:

If there are signs of rhinitis, the use of vasoconstrictor drops is indicated (no longer than 5 days):

The following agents are used as immunomodulatory therapy:

They are effectively used together with antiherpetic drugs (Acyclovir). Rarely, in severe cases of mononucleosis, anti-inflammatory hormonal drugs (Prednisolone) are prescribed. It is imperative to support the child’s body with a sufficient amount of vitamins.

Hepatoprotectors and choleretic agents for liver changes:

If a bacterial infection occurs, antibiotics (except penicillins) are required. At the same time, you need to take probiotics to normalize the intestinal microflora (Linex, Narine).

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A child should be hospitalized if he has:

  • temperature above 39 o C;
  • severe general intoxication;
  • threat of asphyxia;
  • other complications.

Diet and nutrition

A child will recover faster from infection with the virus if he is provided with the correct drinking and eating regimen. During illness, drinking should be plentiful, at least 1.5 liters of water per day. Since infectious mononucleosis affects the functioning of the liver, nutrition should be gentle (stick to it for another ½-1 year after recovery).

The child’s diet should not contain fatty, fried, smoked foods and sweets. Exclude legumes, garlic, onions. Minimize the consumption of sour cream, butter, and cheeses.

Food should be light and rich in vitamins. The menu should include:

Prognosis and possible complications of the disease

In most cases, the prognosis for infectious mononucleosis is favorable. The main condition for eliminating complications is to monitor changes in the blood so as not to miss leukemia and other complications. The child's condition should be closely monitored until complete recovery.

Within a month, the lymph nodes return to their normal size, and the sore throat goes away in 1-2 weeks. For a long time after recovery, the child remains weak, drowsy, and quickly gets tired. Therefore, for another ½-1 year he must undergo clinical observation and check his blood composition.

Complications from mononucleosis are rare. It can be:

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We moved to a new city and became very ill—apparently, it was acclimatization. We went to the hospital, the pediatrician suggested Ixim Lupin, she said something was a 3rd generation antibiotic, it was easily tolerated, especially by small children. As a child, I was treated with bitter pills and a nasty mixture, but here is a sweet suspension. I even envied Varyushka; this never happened in my childhood. Varya drinks it with pleasure, it’s a good drug.

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Mononucleosis is a viral infection that is dangerous for children.

Children and adolescents who are not carriers of the Epstein-Barr virus can become ill if the pathogen enters the body. The infection is transmitted through saliva during kissing, shared dishes, toys, and by airborne droplets. Mononucleosis in children at certain stages is very similar to a cold or hepatitis. In the chronic form, the painful condition often persists for more than 3 months, and bacterial complications are possible. 90% of the population over 30 years old suffered from mononucleosis in early childhood.

Causes of the disease and how the infection is transmitted

Epstein-Barr virus belongs to the group of DNA human herpes viruses. The pathogen multiplies mainly in B lymphocytes; these cells are also associated with the persistence of the virus throughout a person’s life. Mononucleosis in children is transmitted through droplets of saliva and phlegm from the nose, desquamated cells of the epithelium lining the oral cavity. Strains of the pathogen are preserved in toothbrushes, dishes used by sick people and virus carriers.

Features of the causative agent of mononucleosis:

  • The virus spends most of the time in a child or adult body in a latent state, but from time to time it becomes active and begins to multiply.
  • There are acute, chronic or atypical mononucleosis in children. The course and severity of symptoms vary in each case.
  • Possible asymptomatic carriage or a mild form of the disease in children under 10 years of age.
  • Acute mononucleosis mainly affects adolescents and young adults who have not previously been infected with the Epstein-Barr virus.

The duration of the incubation period, symptoms and treatment of mononucleosis depend on the child’s immune status. In 60% of cases, from the moment of infection to the appearance of symptoms, it takes from 7 to 30 days. With chronic mononucleosis in children, the incubation period extends to 4–8 weeks or several months.

Primary and secondary symptoms of mononucleosis

If your child complains of weakness or notices red spots or a rash around his mouth, these signs may indicate an infection with the Epstein-Barr virus. Early symptoms of mononucleosis in children are the same as in a number of other infectious and inflammatory diseases. The child feels a sore throat and nausea for 2–3 days. Then the temperature rises, the tonsils become inflamed, and a rash appears on the face or body.

Sometimes parents are perplexed about what kind of disease has struck their child. Some children cannot study, play, or perform even simple self-care activities. The temperature rise during acute infection reaches 40°C, the condition is especially severe in the evening hours. The lymph nodes in the corners of the lower jaw become enlarged and inflamed. There is an enlargement of the spleen, swelling of the lymph nodes in the groin, under the arms and on the neck. The development of generalized lymphadenopathy is possible.

Secondary signs and symptoms:

  1. anemia;
  2. swelling of the eyelids;
  3. loss of appetite;
  4. hepato-splenomegaly;
  5. photosensitivity;
  6. severe nasal congestion;
  7. headaches and muscle pain;
  8. rashes on the face and torso (in 5% of small patients).

Yellow-white deposits appear on the tonsils. The child complains of pain in the neck, where the lymph nodes are located. Parents should seek immediate medical attention if children have a severe sore throat and difficulty swallowing.

Complications in children with mononucleosis:

  • upper respiratory tract obstruction;
  • inflammation of the heart muscle;
  • meningitis or encephalitis,
  • streptococcal sore throat;
  • liver diseases;
  • splenic rupture;
  • immunosuppression;
  • pneumonia.

The most dangerous thing about mononucleosis is rupture of the spleen. There is pain in the upper left abdomen. There is a rapid heartbeat, difficulty breathing, and increased bleeding. A child in this condition requires emergency assistance.

Diagnosis of the disease

The clinical picture of mononucleosis in children is very similar to other viral, bacterial and parasitic infections (streptococcal tonsillitis, cytomegalovirus, diphtheria, toxoplasmosis). Human herpesvirus-6 causes symptoms resembling mononucleosis in adulthood.

Specialists take into account a complex of signs and symptoms in diagnosis. Before treating an infectious disease, anamnesis data is collected, symptoms, blood counts, and the results of serological and immunological studies are studied.

A complete blood test for mononucleosis in children can detect leukocytosis. Antibodies to the Epstein-Barr virus are determined by enzyme immunoassay. The polymerase chain reaction method helps to find the DNA of the pathogen. Blood, urine, and scraping of oropharyngeal epithelial cells can be used for PCR.

The final confirmation of the diagnosis is a test for mononucleosis in children, which detects white blood cells affected by the virus. These are basophilic lymphocytes with a large nucleus - atypical mononuclear cells. They completely disappear 4 months after the onset of the disease.

Treatment of an infectious disease

Specific therapy for mononucleosis is not required in all cases. Doctors prescribe medications depending on the severity of symptoms. All sick children should stop playing sports and get more rest. With significant effort, serious consequences can occur in the form of splenic rupture and internal bleeding. Damage to the spleen is not the only danger of mononucleosis. The causative agent of the disease weakens the immune system, the body becomes susceptible to other infections.

Aminopenicillins should not be used for mononucleosis; antibiotics do not act on viruses. The effectiveness of antiviral drugs has not been sufficiently proven. Parents should remember this when reading laudatory reviews of Viferon or Acyclovir. To alleviate the condition, the child is given ibuprofen or paracetamol as long as the temperature lasts. Syrups and suppositories with these antipyretic substances are more suitable for young children.

Help with a sore throat will be provided by gargling with warm water and sea salt, water infusions, sage, lemon balm, chamomile, and special solutions from the pharmacy with antiseptic, analgesic and astringent effects. Local anesthetics in the form of sprays and rinses, lozenges contain ambroxol, lidocaine, and plant extracts.

How many days the child will spend in the hospital is determined by the attending physician. Patients are discharged after recovery and observed in the dispensary for 6 months. Recovery of blood counts takes an average of 3 months.

Nutrition for a child with mononucleosis

Healthy foods for a patient with mononucleosis contain easily digestible substances, including a sufficient amount of carbohydrates. Doctors prescribe diet No. 5 for liver dysfunction. The consumption of animal fats should be limited. Among the varieties of meat, it is recommended to choose white - chicken, rabbit. If swallowing is difficult, food is given in liquid and semi-liquid form - porridge, soups.

Ideally, only boiled and stewed foods should be given. After 3-6 months of a strict diet, you can diversify the menu, but focus on following the principles of healthy eating. You should not feed fatty or fried meats, limit the consumption of sausages, sweets, and chocolate.

A sufficient amount of fluid intake is important, at least 1.5–2 liters per day. It is best to give fresh fruit and vegetable juices. Herbal teas with chamomile, rose hips, milk thistle, corn silk, and lemon accelerate the recovery of liver cells during mononucleosis in children. Vitamins B and C in natural products help restore immunity. Folk remedies - garlic and echinacea infusion - are used for their antiviral effect. On the shelves of pharmacies you can find special teas for a diseased liver.

Prevention measures

After the initial infection, the Epstein-Barr virus is present in the human body in a latent form. There is a version of scientists according to which the parasite becomes more active when the immune system is weakened, and its concentration in the host’s saliva increases. This is an opportunity for the virus to “master” the body of a new host.

Specific measures for the prevention of mononucleosis have not yet been developed. It is important to increase the immunological resistance of the child’s body using hardening methods and regularly carry out vitamin therapy. Rinsing the mouth and nasopharynx with herbal infusions helps. After recovery, the child continues to feel significant weakness and fatigue for about a year. A fever and other symptoms are possible, which is why children who have been ill are exempt from vaccinations for a year.

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2 comments

A 4-year-old child just recovered from mononucleosis. The antibiotic did not work, but as soon as they started using Viferon suppositories, the condition began to improve.

Our son suffered from this disease a couple of years ago. Surprisingly, all the symptoms were almost identical to a common cold. Well, in general, the child had no appetite at all, the temperature was correspondingly high, he could only drink water and that was all. Well, no available means helped, so they took me to the doctor. At the local hospital they did all the required tests, and to our horror they diagnosed me with mononucleosis. The doctor prescribed a bunch of antibiotics, of course we were scared at first, after all, the child was small, they didn’t know how he would cope with it. Well, in general, we were in the hospital for 12 days. It seems like everything worked out without consequences, no one got sick anymore.

Source: http://zdorovyedetei.ru/infekcii/mononukleoz-opasnaya-dlya-detej-infekciya-virusnogo-proisxozhdeniya.html

Infectious mononucleosis in children: symptoms, treatment, complications

The disease, called infectious mononucleosis, was first described by N.F. Filatov and became known as idiopathic lymphadenitis. This is an acute infectious viral disease, which is characterized by an increase in the size of the liver and spleen, changes in white blood, a disorder of the reticuloendothelial system, complicated by lymphadenopathy.

It has been proven that the cause of the development of this disease is the Epstein-Barr herpetic virus type 4, which affects the lymphoid-reticular tissue. The virus enters the body by airborne droplets and first infects the epithelium of the nasopharynx, and then, spreading along with the bloodstream, regional lymph nodes. It remains in the human body for life and can recur if the immune system is weakened.

Infectious mononucleosis in children: causes

Children under 10 years of age have the greatest predisposition to this disease. There is a high risk of “catching” the virus in a closed group, for example, in a school or kindergarten, since it is transmitted by airborne droplets. The causative agent of the disease quickly dies in the environment, so you can only become infected with it through very close contact with the carrier.

In a sick person, the virus is contained in particles of saliva, so transmission of infectious mononucleosis from one person to another is possible when:

using shared utensils.

The incidence of infectious mononucleosis among boys is 2 times higher than among girls. The risk of contracting an infection increases in the autumn-winter period, when colds worsen and transmission of the virus becomes possible through sneezing and coughing. Some virus carriers do not feel any signs of illness at all and pose a serious danger to surrounding healthy people. After the virus enters the human body through the respiratory tract, the incubation period of the disease ranges from 5 to 15 days. In individual cases, this period can last up to one and a half months.

Epstein-Barr virus is a very common infection; more than 50% of children under 5 years of age are infected with it, and most of them do not experience serious symptoms of the disease. It is noteworthy that among the adult population, 85-90% of people are carriers of the virus, but only a small proportion of adults and children exhibit symptoms characterizing infectious mononucleosis.

Symptoms of mononucleosis in a child

Since prevention of viral infections is not carried out today, if a child comes into contact with a patient with infectious mononucleosis, parents should closely monitor his health for 2-3 months. If the symptoms of mononucleosis do not appear, then the child has not become infected with the virus, or the immune system has coped with the infection, and nothing threatens health.

If general symptoms of intoxication appear - weakness, fever, rash, chills, swollen lymph nodes - which doctor should I contact? You should first consult your family doctor or pediatrician, and then go to an infectious disease specialist.

The symptoms of infectious mononucleosis are varied. Sometimes general signs of a prodormal nature appear, such as weakness, malaise and catarrhal symptoms. Gradually, the temperature rises to low-grade fever, health worsens, a sore throat is observed, and nasal congestion worsens breathing. Symptoms of the development of mononucleosis also include pathological proliferation of tonsils and hyperemia of the mucous membrane of the oropharynx.

Sometimes the disease begins suddenly and has pronounced symptoms. In this case it is possible:

increased sweating, weakness, drowsiness, chills;

fever, which can occur with an increase in temperature up to several degrees and lasts for several days and even a month;

symptoms of intoxication - pain when swallowing, muscle aches, headache.

At the culmination of the disease, the main features of infectious mononucleosis appear, such as:

tonsillitis - on the back wall of the pharyngeal mucosa, granularity, follicular hyperplasia, hyperesia occurs, and hemorrhage in the mucosa is possible;

lymphadenopathy - an increase in the size of the lymph nodes;

lepatosplenomegaly – enlargement of the spleen and liver;

skin rash all over the body;

general intoxication of the body.

With mononucleosis, the appearance of a rash is most often observed at the onset of the disease, simultaneously with lymphadenopathy and fever, and it can be very intense, localized on the back, abdomen, face, arms and legs in the form of small pale pink or red spots. The rash does not need to be treated, because it does not itch and disappears as the immune system fights the infection. If a child is prescribed an antibiotic and the rash begins to itch, this indicates an allergy to the drug (most often penicillin antibiotics are prescribed - Amoxicillin, Ampicillin and others).

The most striking sign of infectious mononucleosis is polyadenitis. This disease occurs as a result of hyperplasia of lymphoid tissue. In most cases, island-shaped deposits of a whitish-yellowish or gray hue are formed on the tonsils of the palate and nasopharynx. They have a lumpy, loose consistency and are easy to remove.

Peripheral lymph nodes also enlarge. They contain an actively reproducing virus. The lymph nodes located on the back of the neck grow the most: when the child turns his head to the side, they become visually noticeable. Interconnected lymph nodes located nearby are also affected by the virus, so infection is always bilateral.

When palpating the lymph nodes, pain almost does not appear, since the nodes are not in close contact with the skin and are mobile. In some cases, an increase in the lymph nodes of the abdominal cavity is observed, which provokes the development of symptoms of an acute abdomen. This can lead to misdiagnosis and unnecessary surgery.

A characteristic symptom of infectious mononucleosis is hepatosplenomegaly - pathological enlargement of the liver and spleen. These organs are very susceptible to the virus, so changes in them appear already in the first days after infection.

The spleen can enlarge to such a size that its walls cannot withstand the pressure and the tissue ruptures. When the body temperature approaches normal values, the functioning of the liver and spleen normalizes.

Diagnosis of the disease

To confirm the diagnosis of infectious mononucleosis in a child, the doctor usually prescribes further tests:

blood test for the presence of IgG, IgM antibodies to the Epstein-Barr virus;

Ultrasound of internal organs, primarily the spleen and liver;

biochemical and general blood test.

Diagnosing childhood infectious mononucleosis is quite difficult. The main signs of the disease are tonsillitis, enlarged lymph nodes, liver and spleen, and fever. A doctor cannot determine by eye whether a child has a common sore throat or infectious mononucleosis; this requires serological tests. Hematological changes act as secondary symptoms of the disease.

Blood test for childhood mononucleosis

The results of a complete blood count show the number of monocytes, lymphocytes and leukocytes. Based on these indicators, one can judge the presence of an infectious disease.

It is important to take into account the indicator of atypical mononuclear cells - cells with large basophilic cytoplasm. The development of infectious mononucleosis is indicated by their blood content at 10%. One should take into account the fact that atypical blood elements cannot be detected immediately, but only several weeks after infection. Such mononuclear cells are round or oval elements, the size of which can be similar to the dimensions of a large monocyte. They are otherwise called “wide-plasma lymphocytes” or “monolymphocytes.”

When determining the diagnosis, it is important to exclude various types of tonsillitis and tonsillitis, acute leukemia, Botkin's disease, diphtheria of the pharynx and lymphogranulomatosis, which are similar in symptoms. To make a correct diagnosis, the presence of antibodies to the Epstein-Barr virus is determined. There are also quick laboratory research methods that allow you to get results in the shortest possible time, for example PCR.

People affected by infectious mononucleosis undergo a series of serological tests for the presence of HIV infection every few months, because it, similar to the Epstein-Barr virus, helps to increase the level of mononuclear cells in a person’s blood.

If symptoms of sore throat occur, it is recommended to visit an otolaryngologist and undergo a pharyngoscopy, since the disease can have different origins.

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

If there is an adult or child in the family who has infectious mononucleosis, it is quite difficult not to infect other family members, since the virus is easily transmitted by airborne droplets. Even after recovery, a child or adult is able to release the virus into the environment along with particles of saliva.

Therefore, there is no need for quarantine for this disease, and even if family members do not become infected with the virus at the time the child’s disease relapses, there is a high probability that infection will occur later, when the patient recovers and returns to his usual lifestyle. In case of a mild form of the disease, isolation of the child is not required; he can safely attend classes at school after recovery.

Features of the treatment of childhood infectious mononucleosis

Modern medicine does not know a universal treatment for the disease in question; there is no specific antiviral drug that can effectively resist the Epstein-Barr virus. Traditionally, the disease is treated at home and only in severe forms of mononucleosis the patient is hospitalized and prescribed bed rest.

Clinical indications for placing a patient in a hospital:

body temperature from 39.5 and above;

clear manifestation of symptoms of intoxication.

The following treatment options for childhood infectious mononucleosis are distinguished:

therapy aimed at eliminating the symptoms of mononucleosis;

pathogenetic treatment in the form of taking antipyretic drugs for children (“Paracetamol” in syrup, “Ibuprofen”);

local antiseptics for relieving sore throat, as well as drugs such as “IRS 19” and “Imudon”;

taking destabilizing agents.

vitamin therapy - taking vitamins (B, C and P-group);

if abnormalities in the liver are detected, a special diet is prescribed, in particular hepatoprotectors and choleretic drugs;

the best results in treatment are shown by the use of antiviral drugs together with immunomodulators; in particular, “Cycloferon”, “Viferon”, children’s “Anaferon”, “Imudon” are prescribed at a dosage of 6-10 mg/kg; treatment is also well supported by taking drugs based on metronidazole (“Flagil”, “Trichopol”);

due to the addition of secondary microbial flora, the use of antibiotics is indicated, which are prescribed only in case of intense inflammation in the oropharynx or the presence of complications (in most cases, antibiotics cause allergic reactions);

It is mandatory to prescribe probiotics (“Primadofilus” for children, “Acipol Narine”, etc.).

in severe cases of the disease, short-term use of prednisolone is indicated (it is prescribed if there is a risk of afictation);

installation of a tracheostomy and transfer of the patient to artificial ventilation is performed only when severe swelling of the larynx and difficulty breathing in the child are observed;

If the spleen has ruptured, a splenectomy is performed immediately.

Prognosis and consequences of infectious mononucleosis

When a child’s body is damaged, as a rule, the prognosis for recovery is quite favorable. However, an important condition for the absence of complications and consequences is regular monitoring of blood composition and diagnosis of leukemia. You should also monitor the child’s condition until complete recovery.

In one of the clinical studies conducted to determine the duration of the recovery process in adults and children after mononucleosis, 150 people took part. Doctors monitored the patients' health status for six months.

The following research results were obtained:

It is normal when the body temperature is maintained at 37.5 degrees; low-grade fever during this period is also not a deviation.

With infectious mononucleosis, sore throat and sore throat are characteristic of the first two weeks of the disease.

The size of the lymph nodes normalizes during the first month of the disease.

Weakness, increased fatigue and drowsiness can be observed for a fairly long period - from a month to six months.

Therefore, for children who have recovered from the disease, a clinical examination is necessary for 6-12 months in order to monitor the residual effects of mononucleosis in the blood.

Complications of the disease are quite rare, but the most common among them is considered to be inflammation of the liver, which contributes to the development of jaundice with a characteristic yellowing of the skin and darkening of the urine.

One of the most severe consequences is splenic rupture, which occurs in 0.1% of cases. This occurs with the development of thrombocytopenia and overstretching of the linear capsule, which entails rupture of organ tissue. This is a very dangerous condition, which can result in death.

It is also possible to develop meningoencephalitis (enlarged tonsils and airway obstruction), severe forms of hepatitis and interstitial infiltration of the lungs.

The results of many scientific studies indicate a connection between the Epstein-Barr virus and the development of rare types of cancer (various lymphomas). But this does not mean at all that a child who has had infectious mononucleosis can develop cancer. Lymphomas occur only if the patient's immunity is sharply reduced.

It should be noted that at the moment there is no effective prevention of infectious mononucleosis.

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