Mononucleosis is an acute viral disease that entails damage to the reticuloendothelial and lymphatic systems. Its causative agent is Epstein's virus, which belongs to the herpes group. The disease is serious, difficult to tolerate.
How does infection happen? What are the symptoms of mononucleosis? How is the diagnosis carried out? What is needed for treatment? We will talk about this and much more with our article.
Infection
The distributor of this disease is an infected person. From it, other healthy people can also “pick up” the infection by airborne droplets or by contact. You can get mononucleosis by kissing a sick person, using his towel, drinking from his bottle.
Children usually become infected using common toys. Also, the virus is transmitted during blood transfusion (blood transfusion), from mother to child during pregnancy. However, it should be noted that children have innate immunity to this herpes virus, therefore, during the first year of life, they are immune to it.
People are easily infected with this virus, but, as a rule, the disease is mild. Therefore, the symptoms of mononucleosis are often subtle, similar to the signs of many other ailments. The peak incidence occurs in adolescence (14-18 years).
But people after 40 years rarely get infected with it. It should also be noted that the peak incidence occurs in spring and autumn. In addition, a powerful epidemic surge is recorded every 7 years. While scientists do not know for what reasons this is happening.
Danger of disease
In simple terms, the virus, entering the bloodstream, immediately begins to attack B-lymphocytes - cells of the immune system. Once in the mucous membrane, he remains in it forever.
This herpes virus does not lend itself to complete destruction, like other pathogenic microorganisms of this group. There is currently no effective vaccine against this virus. The main problem in its creation is the difference in the composition of proteins at different stages of its existence.
Once an infected person until the end of his life remains a carrier of Epstein viruses - Barr. But their activity can be blocked, so it is so important not to neglect the treatment.
It should also be noted that viruses, once inside the immune cells, lead to their transformation. As they multiply, they develop antibodies to themselves, as well as to infection.
Over time, the intensity of their distribution increases. Soon parasitic cells fill the lymph nodes and spleen, which provokes their increase.
It should be noted that antibodies are extremely aggressive compounds. Under certain conditions, they may begin to take body cells for foreign agents, which lead to the formation of diseases such as Hashimoto's thyroiditis (inflammation of the thyroid gland), rheumatoid arthritis, lupus erythematosus, and diabetes mellitus.
Disease development
The first symptoms of mononucleosis may not appear immediately. The incubation period lasts from 5 days to 1.5 months. A prodromal stage is also possible. It occupies a temporary niche between the incubation period and the disease itself. During its course, a manifestation of some symptoms that are not specific may be observed.
The gradual development of the disease is characterized by the following symptoms:
- Low-grade body temperature. Over a long time, it rises in the range of 37.1–38.0 ° C.
- Malaise, causeless weakness and increased fatigue.
- Catarrh of the upper respiratory tract. Manifested in nasal congestion, hyperemia of the mucous membrane of the oropharynx (vascular overflow) and an increase in tonsils.
Further more serious symptoms of mononucleosis appear. By the end of the first week, the following symptoms appear:
- Rapid rise in temperature. It can reach very high levels, up to 40 ° C.
- Severe sore throat, which is worse when swallowing and yawning.
- Intense chills and sweating.
- Body aches.
- Enlarged lymph nodes (lymphadenopathy).
- General toxic effects.
- An increase in size and disruption of the liver and spleen (hepatolienal syndrome).
- Nasal congestion and shortness of breath, nasal voice.
- A yellowish coating on the tonsils (similar to those that occur with diphtheria).
- A hemorrhagic rash appears on the mucosa of the soft palate. It, as a rule, has a loose, granular character.
Over time, temperature indicators change, and fever can last from a couple of days to several months.
Often angina develops (ulcerative necrotic, membranous, catarrhal or follicular), icteric syndrome appears, accompanied by a decrease in appetite and nausea. Patients may experience dark urine and icteric sclera.
In especially severe cases, exanthema is formed - a skin rash of the viral nature of the papular-spotted type. It passes quickly and leaves no traces.
The acute form of the disease lasts about 2-3 weeks. Then comes the period of convalescence. At this time, there is a restoration of immunity, the pathogen is excreted from the body. Functions impaired during the disease are restored.
But this period will not come if you do not pay attention to the symptoms of mononucleosis in time and start treatment. Otherwise, remission will not occur. On the contrary, the disease will worsen and entail complications.
Symptoms of mononucleosis in children
This topic needs to be considered separately. In babies, the disease manifests itself with symptoms similar to those listed above. The child has:
- Slow fever.
- A characteristic swelling of the glands.
- Angina caused by inflammation of the pharyngeal and palatine tonsils (tonsillitis).
- Fatigue and physical discomfort.
- Runny nose, pain in the head and stomach.
- Difficulty swallowing, bleeding gums.
- Joint pain.
As a rule, the symptoms of mononucleosis in children are observed within a few weeks. However, in rare cases, the disease can last for months.
Due to severe fatigue and chronic fatigue, the child needs a long sleep. It is important to make a reservation that the disease can occur both in a typical and atypical form, which is characterized by a characteristic severity.
Symptoms of mononucleosis in young children are most pronounced. The disease is more difficult for them. Kids can hardly tolerate mononucleosis. In them, it can be accompanied by the development of such consequences:
- Decreased platelet count in the blood (thrombocytopenia).
- Changes in the central nervous system.
- Enlarged spleen and liver.
But children do not have a very high fever, rash and sore throat.
If treatment is started on time, then the disease can be eliminated in 3-4 weeks. But the composition of the blood can continue to change for six months. That is why it is important that the child continues to be under the supervision of doctors.
Diagnostics
Its implementation is necessary if there is a suspicion of symptoms of mononucleosis. Treatment and prevention in children and adults is carried out exclusively under the supervision of a specialist. Before the appointment of procedures and therapy, a diagnosis must be made.
After a visual examination and questioning, the doctor may order a study of the cellular composition of the blood.
If a person is really sick with mononucleosis, then the analysis will show moderate leukocytosis with a predominance of monocytes and lymphocytes. Neutropenia is also detected - a low level of neutrophilic granulocytes.
With this disease, atypical mononuclear cells appear in the blood, which are large cells of a very different shape with a wide basophilic cytoplasm. Often their number is more than 80% of all elements of white blood.
It happens that during the study, if it is carried out in the first days after a probable infection, mononuclear cells are absent. However, this does not preclude a diagnosis. Because these cells form within 2-3 weeks.
Virological diagnosis of mononucleosis is not carried out, due to the irrationality and complexity of the process.
Also, very often, to confirm the diagnosis, they resort to a serological diagnostic method - they detect antibodies to the VCA antigens of the virus.
After the symptoms of mononucleosis disappear (the photo of the pathogen provoking them, presented above), specific immunoglobulins G still live in the blood for a long time. A recovered person will need to undergo examinations aimed at eliminating the likelihood of HIV infection (mononuclear cells are also present in the blood) .
Opinion Komarovsky
Evgeny Olegovich Komarovsky is a pediatrician of the highest category, the words of which are listened to by many parents whose child has suffered a disease. You can learn a lot of useful things by studying his works on mononucleosis in children. Komarovsky talks in detail about the symptoms and treatment. The doctor notes that children under the age of 2 years rarely get sick. If they become infected with this infection, then they tolerate it easily. More often, mononucleosis overcomes children older than 3 years.
You should be alert if the child begins to tire quickly, breathe through the mouth and snore heavily. This is due to sore tonsils and swelling of the adenoid tissue. Also, the child may lose appetite.
All of the above symptoms of mononucleosis in children are also observed. Komarovsky claims that after the onset of remission, vaccinations are prohibited for the child for a further 6-12 months. Parents need to limit their child’s contacts with people. He is contraindicated in sun exposure. Another important task is to restore immunity in the sick child as much as possible, for which the children's body needs improved nutrition.
Effects
Much has been said above about the symptoms and treatment of mononucleosis in children and adults. It is worth listing the possible complications, which, fortunately, rarely occur. These include:
- Rupture of an enlarged spleen. It is fraught with massive internal bleeding. Symptoms: sudden pain in the side, dizziness, pallor, darkening in the eyes, fainting.
- Joining a bacterial infection. At the peak of the disease, the body is exposed to viruses. If they get on the mucous membranes, they can lead to bronchitis, sinusitis and tonsillitis. Symptoms: a new wave of fever, deterioration of health, increased pain in the throat.
- Labored breathing. Enlarged tonsils lead to this, which are so large that they close together. The same is fraught with an increase in lymph nodes.
- Hepatitis. Infectious mononucleosis is characterized by liver damage. Perhaps even the formation of jaundice.
- Meningitis. This complication is one of the rarest. Symptoms of damage to the membranes of the brain become a persistent headache, convulsions and vomiting.
In addition, with mononucleosis, hematological complications are possible. The most common are thrombocytopenia and anemia.
Drugs for treatment
Talking about the causes and symptoms of mononucleosis, it is impossible not to discuss how treatment is carried out for this disease. Of course, the doctor prescribes the therapy. It is not recommended to engage in self-medication, as this can even further damage health. Doctors usually prescribe the following drugs:
- Ergoferon. This is a homeopathic remedy that has an immunomodulating and anti-inflammatory effect. It activates nonspecific immunity, which helps fight the virus. Effective against many respiratory, intestinal, bacterial and herpetic infections.
- "Isoprinosine." A synthetic derivative of purine, which has an antiviral and immunostimulating effect. It also prevents a decrease in the activity of lymphocytic cells, stimulates T-lymphocytes, destroys viruses.
- Flavozide. Syrup made on the basis of flavonoids. Suppresses the replication of RNA and DNA viruses, protects the mucous membranes of the upper respiratory tract, increases the level of sIgA and lactoferin. Even its single use leads to the synthesis of interferon, lasting about 6 days.
- "Echinacea compositum C". Combined homeopathic remedy that effectively eliminates the symptoms of mononucleosis in adults. Its composition is a combination of four nosodes, thanks to which it is possible to strengthen the immune system and eliminate the hidden foci of the disease as quickly as possible.
- Amizon. An effective drug that has immunomodulating and antiviral effects. It also has interferonogenic properties, contributes to an increase in the concentration of endogenous interferon in the blood plasma. In addition, this tool significantly increases the body's resistance to various viral infections.
- Anaferon. The drug has antiviral activity. Increases overall body resistance.
These are the main drugs used to treat symptoms of mononucleosis in adults. In addition to taking medications, a person will have to avoid contact with other people for at least 10-15 days. Bed rest can also be assigned. It is important at this time not to carry out heavy physical work and not to engage in sports.
How to treat children
In order to avoid complications and consequences, the symptoms of mononucleosis in children, as well as adults, must be paid attention to immediately and promptly begin treatment. The child is shown detoxification therapy and taking drugs that have a restorative and desensitizing effect.
Also, symptoms are removed by the use of non-steroidal anti-inflammatory drugs (Ibuprofen, for example) and antipyretics.
Inflammation and sore throat can be eliminated by drugs such as Bioparox and Hexoral. It is best to opt for drugs that do not contain ethanol. The child is suitable "Iodinol", "Furacilin", infusion of chamomile.
If complications arise, the pediatrician prescribes such drugs as Ganciclovir, Acyclovir, and Viferon.
Antibiotics are taken very rarely. They do not help fight infection, but cause side effects. Their reception is indicated for complications. In particular, with meningitis, otitis media, pneumonia and tonsillitis. But even in this case, it is better to opt for a new generation of cephalosporins and macrolides.
Restorative therapy
During an illness, it is important not only to take medications prescribed by a doctor, but also to follow some recommendations that help strengthen immunity and maintain health. It is necessary:
- Take bifidobacteria. They help to suppress the reproduction of pathogenic microorganisms.
- Drink vitamins or whole complexes. You do not even need to talk about their benefits - without these substances, the body cannot function normally.
- Drink plenty of fluids (clear water, weak green or herbal tea).
- Use non-steroidal anti-inflammatory drugs to lower fever.
- Rinse the oropharynx with antiseptics with a small amount of lidocaine, a local anesthetic.
- Use folk remedies - decoctions of mint, chamomile, rose hips, dill.
- Drink linden tea with lemon balm and lemon, which not only soothes, but also helps to cope with disorders of the nervous system and intoxication.
- Use infusions based on ginger root or a decoction of bog calamus for edema.
- To remove pain with a decoction of dandelions.
A full rest and regular walks in the fresh air are also required.
Of course, all patients need a diet. Much has been said above about what kind of disease it is - mononucleosis, and about the symptoms that are observed with it .. With this ailment, it is very difficult to swallow. In addition, mononucleosis can cause liver damage.
It is important to eat foods that are rich in protein and carbohydrates. It is necessary to actively eat fish, lean meat, vegetable soups, fresh vegetables and fruits, dairy products. But fatty, spicy, salty and heavy foods must be discarded. “Sharp” products are also contraindicated - garlic, coffee, onions, horseradish, vinegar, marinades.
Observing these recommendations and performing treatment, the symptoms of mononucleosis and the disease itself can be eliminated without problems.