Mononucleosis disease refers to common infectious diseases that occur acutely and affect the lymph nodes and internal organs. At the same time, the blood reaction is changing.
Mononucleosis in adults: historical data
For a long time, the disease was considered only as a lymphatic reaction due to other infections. His independent clinical picture was first described in 1885 by N.F. Filatov. He drew attention to the fact that the underlying disease is an increase in lymph nodes, and called it glandular fever. For several years, mononucleosis was described as monocytic tonsillitis and other infections. The currently common name for the disease was received only in 1902.
Mononucleosis in adults: etiology
The causative agent of the infection is the Epstein-Barr virus, which can reproduce even in lymphocytes. It does not lead to the death of cells, but rather provokes their division and reproduction. Viral particles contain several antigens, each of which is formed in a certain order. Then, in the same order for each of them, the corresponding antibodies are synthesized in the blood of a sick person.
In the external environment, the virus is almost unstable, and when dried, high temperature and exposure to disinfectants, and completely die.
Mononucleosis in adults: signs
The range of the incubation period is quite wide: from four days to a month, but on average it lasts a week or two. Sometimes the disease is so easy that a person does not seek medical help. But more often it still begins with a gradual or sharp fever. The patient has a severe headache, which causes suspicion of meningitis. The febrile period can last only 4 days, and can last up to two months.
A constant symptom of the disease is an increase in lymph nodes. Most clearly affected are those located along the posterior edge of the sternocleidomastoid muscle. The nodes are painful to feel. After three or four days, they reach the size of a walnut. Other glands (inguinal, mesenteric, axillary, mediastinal) can also be involved in the process.
In most cases, the spleen enlarges and tightens. On palpation, it does not cause pain.
The next symptom is tonsillitis. It may be absent in rare cases. Angina can occur both from the very beginning of the disease, and after a few days. By nature, it can be lacunar, catarrhal, or ulcerative diphtheria. In the latter case, mononucleosis in adults is difficult to differentiate from diphtheria of the pharynx. And, of course, a cardinal symptom is a change in blood. At the beginning of the disease, leukocytosis is observed. The content of mononuclear cells reaches 40-90%. ESR remains normal or rises slightly. There are no deviations from hemoglobin and red blood cells either. In some cases, all symptoms disappear within 10-15 days, but sometimes even after the cessation of fever, the lymph nodes and spleen remain enlarged for a long time, and the change in blood composition is delayed.
Mononucleosis: diagnosis
Under laboratory conditions, disease recognition is based on a response to heterophilic antibodies. The fact is that by the end of the first week hemagglutinins to erythrocytes of some animals sharply increase in human blood. Mononucleosis in adults needs to be differentiated from many other diseases. So, from Vincent's sore throat and diphtheria it is distinguished by the characteristic formula of leukocytes and an enlarged spleen. From tularemia - the presence of atypical cells in the blood .