Infrequently, adults suffer from infectious mononucleosis. Most of them have already formed antibodies to this virus by the age of forty and have developed a stable immunity. However, the likelihood of infection still exists. It is noted that people aged are more likely to tolerate the disease than children. In this article, we will try to figure out what it is - mononucleosis in adults, how you can get infected, what are its symptoms and how to treat it.
Briefly about the discovery of the disease: historical facts
Mononucleosis is an infectious pathology that proceeds in an acute form with a high temperature. In this case, damage to the lymph nodes and pharynx, spleen and liver is noted, and a change in the composition of the blood also occurs. The disease was discovered as early as 1887 by N.F. Filatov and for a long time bore his name. Then the German scientist Ehrenfried Pfeiffer described a similar disease and called it glandular fever.
Later, American scientists T. Sprant and F. Evans conducted a study of changes in blood composition and called the disease an infectious mononucleosis. What is it in adults? As it turned out, its causative agent is the Epstein virus - Barr, named after the scientists who discovered it, and belongs to the herpes family. It can stay in the human body for a long time without manifesting itself. Infection occurs from a sick individual, including those with an erased form of the disease, or the carrier of the virus.
The mechanism of the development of the disease
Mononucleosis in adults - what is it? An infectious disease occurs when the pathogen, once in the respiratory tract, affects the epithelium and the lymphoid structure of the oral cavity and pharynx. There is swelling of the mucous membranes, hypertrophy of the lymph nodes and tonsils. The infection invades B cells and spreads rapidly throughout the body. Atypical mononuclear cells (modified mononuclear cells) appear in the patient’s blood.
There is an overgrowth of lymphoid and reticular tissue, which forms the basis of hematopoietic organs. Due to this, there is an increase in the spleen and liver. In severe cases, necrosis of lymphoid organs, the formation in the tissues of cellular elements with an admixture of blood and lymph in the lungs, kidneys and other organs are possible.
What contributes to the occurrence of pathology?
The cause of mononucleosis in adults is the Epstein-Barr virus, which is part of the herpes family. The source of the disease is a sick person with any form of infectious mononucleosis. The virus does not have much activity, therefore, infection requires a long and close contact. The main ways of infection of adults:
- Airborne - when sneezing and coughing, the virus, along with saliva, can enter the mucous membranes of another person.
- Contact household - kisses, the use of the same dishes and hygiene items.
- Genital - The virus is present in all internal fluids, including sperm.
- With a blood transfusion, an organ transplant, using one syringe to use drugs.
It is noted that the virus quickly dies in the environment, and lives in the body for life, integrating into the DNA of B-lymphocytes. Therefore, the patient develops a stable immunity for life, and repeated attacks of the disease are the restoration of his viability with a decrease in the body's defenses.
Symptoms of the disease
The incubation period is from several days to one and a half months. Signs of mononucleosis in adults appear as follows:
- The oral cavity and pharynx are affected. Palatine tonsils increase, which leads to shortness of breath, hoarseness. In the early days of the disease, tonsils are covered with a thick white coating. Discharge of mucus from the nose is not always present, but there is nasal congestion.
- Enlarged lymph nodes. Inflamed on the neck, nape of the elbows and intestines, but they remain mobile, not connecting with the underlying tissues.
- Temperature. There is a sharp rise to 39-40 degrees.
- Enlarged spleen and liver. A week after the development of the disease, the organs reach their maximum size. In this case, yellowness of the skin and sclera of the eyes are sometimes observed. Organ enlargement lasts up to three months.
- Skin rashes. With the active development of the disease, a rash appears on the skin, similar to measles or scarlet fever. In the oral cavity, in the palatine region, there are point hemorrhages.
- Disorders of the cardiovascular system. Possible tachycardia, systolic murmurs and decreased heart sounds.
When treating mononucleosis in adults, symptoms disappear after two to three weeks, but atypical mononuclear cells are still found in the blood for a long time.
The clinical picture of the chronic course of the disease
Unlike the acute form, the disease is sluggish, and all the symptoms are mild:
- The patient feels weakness, drowsiness, slight malaise, headaches.
- The temperature is between 37.2–37.5 degrees.
- There are weak, aching and painful sensations in the throat. Purulent plugs come out of lacunae with an unpleasant odor.
- Cervical and hyoid nodes are inflamed, pulling pain is felt when talking, turning the neck.
- Skin rashes in chronic mononucleosis in adults are not significant, can be present on the neck, chest, arms and face.
- The nasal passages are blocked, the mucus is small.
- A slight enlargement of the liver and spleen is also present.
Signs of damage to the gastrointestinal tract and lungs are not observed. After about a week, the symptoms of the disease disappear on their own, but the disease is not cured. Once in the body, the Epstein-Barr virus remains in it for life. At the same time, he makes himself felt as soon as the weakening of the immune system occurs, and each time manifesting itself in different ways.
Diagnosis of the disease
To identify viral mononucleosis in adults, an accurate diagnosis is necessary to visit a general practitioner who:
- During the conversation with the patient, he will collect a medical history - when it started, complaints, the nature of the pain, general condition.
- Will conduct an external examination of the skin, throat, palpation of the lymph nodes, liver, spleen.
After examination, to clarify the preliminary diagnosis, laboratory tests will be required:
- Clinical blood test - determination of atypical mononuclear cells.
- Blood biochemistry will detect bilirubin levels.
- ELISA (enzyme-linked immunosorbent assay) diagnoses the Einstein-Barr virus.
- PCR (polymerase chain reaction) will establish the number of pathogen cells.
- The serological method will determine the presence of antibodies to Epstein-Barr virus antigens.
The entire range of studies helps to detect the disease and make a diagnosis in order to proceed with treatment.
Infectious Disease Pharmacotherapy
In mild forms of the disease, treatment is carried out on an outpatient basis, and in severe cases, in the infectious diseases departments of the hospital. In the acute period, the patient must observe bed rest, in addition, he is recommended to drink plenty of drinks: fruit drinks, compote, tea and light diet meals. The following medications are used to treat symptoms of mononucleosis in adults:
- Antipyretic drugs - to normalize body temperature: Nimesulide, Ibuprofen.
- To maintain the immune system - "Interferon-alpha."
- Antiviral - activate the body's resistance to viruses: Cycloferon, Tiloron.
- Antibiotics - used if necessary to prevent bacterial infections: Azithromycin, Ceftriaxone.
- Glucocorticoids - prescribed when there are problems with the respiratory system: "Dexamethasone", "Prednisolone".
- Solutions for intravenous administration - reduce intoxication, facilitate the well-being of the patient: "Dextrose", saline.
- Vitamin-mineral complexes - to restore the body.
The average duration of treatment is from two weeks to a month. After this, the patient for a year is on the clinical records, passing every three months laboratory monitoring of blood counts.
Mononucleosis in pregnant women
Often the disease in expectant mothers begins with a sharp increase in temperature, sore throat and inflammation of the lymph nodes. At the same time, general malaise, fatigue and drowsiness are observed. In some cases, the symptoms are more pronounced. If any ailments occur, a woman in labor must consult a doctor who will conduct a full examination and prescribe treatment. It is known that infectious mononucleosis does not adversely affect the fetus, but complications are dangerous. There is no special treatment for this disease, so it will consist of rest, constant monitoring of temperature, compliance with the water regimen and taking medications that alleviate the symptoms of the disease that the doctor will prescribe. Vegetables, fruits, natural juices and vitamin complexes will help restore the immune system and cope with the disease faster.
If the pathology overtook a woman during the period of pregnancy planning, then it is recommended to postpone conception until full recovery for six months or a year. The same restrictions apply to the future father.
The consequences of mononucleosis in adults
Usually the disease develops predictably. The acute stage lasts from a week to three. Further, the patient's condition stabilizes: the catarrhal symptoms disappear, the lymph nodes decrease, the tests normalize.
All the consequences of the disease that occur when affected by the Epstein-Barr virus are due to a sharp decrease in immunity. Complications vary in terms of manifestation, they arise both during the illness or immediately after it, and appear in a later period. Despite the fact that the disease has a favorable outcome and rarely threatens life-threatening conditions, you need to know about them. Complications of mononucleosis in adults are of the following nature:
- Diseases of the respiratory tract - obstruction of the upper respiratory tract, sinusitis, bronchitis, tonsillitis, pneumonia, otitis media.
- Meningitis - inflammation is accompanied by headache, nausea, vomiting, cramps, impaired coordination.
- Hepatitis - yellowness of the skin and eyeballs appears.
- Myocarditis - damage to the heart muscle. There is pain in the heart, the rhythm is broken, the limbs swell.
- Jade is an inflammation of the kidneys. It is characterized by low back pain, weakness, temperature.
- Rupture of the spleen - leads to internal bleeding, the patient appears dizzy, sudden abdominal pain, fainting. Without urgent surgical intervention - the threat of death.
It is very important to notice signs of worsening health status in time and consult a doctor to prevent serious consequences.
Diet food
Adhering to mononucleosis diet in adults is very important. Table 5 is recommended for patients, which excludes the use of smoked, spicy, fried, pickled and fatty dishes. And also advised to abandon sweets, alcohol-containing drinks and coffee. The following recommendations will help restore your immune system and improve your health:
- Eat small meals up to six times a day.
- Prepare the broth for the first dishes from lean meat or vegetables.
- For cooking cereals, more often use whole grains: brown rice, wheat and oats.
- Steamed meat dishes, bake in the oven or boil using fresh meat from rabbit, turkey, chicken or veal.
- For fish dishes, purchase pike, pike perch, cod, haddock, tuna.
- Pay special attention to vegetable dishes. For their preparation, cabbage, tomatoes, beans, broccoli, peppers, spinach and all leaf crops are suitable.
- Fruits are needed to replenish the body with vitamins, minerals and fiber. Very useful are bananas, apples, strawberries and all citrus fruits.
- Drink more fluids: fruit and vegetable juices, herbal teas, compotes, fruit drinks.
Proper nutrition will help maintain a healthy state.
Mononucleosis in adults: reviews
Sick individuals on the forums share their impressions of the disease. They note that viral mononucleosis:
- The symptoms of tonsillitis appearing in a few days are supplemented by a reddish rash, similar to an allergic reaction and discomfort in the liver. Only a visit to the doctor and studies help to correctly identify the disease.
- Often begins with the symptoms that usually accompany sore throat: the temperature rises sharply, a sore throat appears and a strong weakness is felt. Only a doctor diagnoses "mononucleosis" in adults whose blood test contains atypical mononuclear cells.
- It may recur from time to time, although a new infection does not occur. The virus in patients who have been ill remains in the body throughout life. When the immune system is weakened, signs of the disease return.
- You can prevent the disease by eating properly, constantly maintaining physical fitness and avoiding stressful situations.
In addition, everyone recommends not delaying a visit to a doctor when identifying symptoms, because serious complications sometimes occur.
How to protect yourself from the Epstein-Barr virus?
In order to prevent mononucleosis in adults, it is important to strengthen the immune system and observe hygiene measures. To do this, you must:
- During the period of mass colds, avoid visiting crowded places.
- Use the mask when you come to the doctor.
- Do not have sex with casual partners.
- Eat right: eat more fruits and vegetables, use lean meat: chicken, turkey, veal, rabbit, eat fish and dairy products, drink natural juices, fruit drinks and fruit drinks.
- Take multivitamin complexes several times a year.
- More often to be in the fresh air, take long walks, engage in all kinds of sports and physical education. Pay special attention to swimming, cycling, Nordic walking.
Now you know what it is mononucleosis in adults. This is a serious ailment, as a result of which the performance of important organs, especially the liver and spleen, suffers. It should be noted that specific preventive measures to prevent it have not been developed. To protect yourself, it is enough to follow the general measures for the prevention of colds and direct all your efforts to strengthening the immune system.