Mononucleosis - Causes, Symptoms And Diagnosis Of Mononucleosis, Consequences, Treatment And Prevention

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Mononucleosis

Causes, symptoms and diagnosis of mononucleosis, consequences

Definition of mononucleosis

Infectious mononucleosis (mononitic sore throat or glandular fever) is a disease caused by the filtering Epstein-Barr virus (human B-lymphotropic virus), which belongs to the group of herpes viruses. It can be present in human cells for a long time in the form of a latent infection.

Children are most often affected, with outbreaks occurring all year round, but the highest incidence is achieved in the fall months. They get sick with mononucleosis once, after which lifelong persistent immunity is developed.

Causes of mononucleosis

The disease is transmitted from a sick person in an acute period, and with erased forms of the disease, the virus carrier is also the source. Usually, infection occurs through close contacts, when the virus spreads by airborne droplets, with kissing, transmission is possible through blood transfusions, while traveling in public transport, when using other people's hygiene products.

Mononucleosis affects children with weak immunity, after suffering stress, with severe mental and physical stress. After the primary infection, the virus is released into the external space for 18 months. The incubation period is 5 to 20 days. Half of the adult population is infected during adolescence.

In girls, infectious mononucleosis occurs at the age of 14-16, and boys are exposed to the disease at 16-18. Rarely, the disease affects people over 40 years old, as antibodies to the virus are present in the blood of adults. What is the reason for the rapid development of infection in an infected body? During the acute phase of the disease, some of the affected cells die, being released, the virus infects new, healthy cells.

When cellular and humoral immunities are violated, superinfection develops and a secondary infection builds up. It has been noted that the Epstein-Barr virus is capable of infecting lymphoid and reticular tissues, resulting in the appearance of generalized lymphadenopathy, enlargement of the liver and spleen.

Symptoms of mononucleosis

Mononucleosis is characterized by fever, lesions of the pharynx (tonsillitis) and lymph nodes, enlarged tonsils, severe sore throat, enlarged liver and spleen, changes in blood composition, and sometimes it can become chronic. From the first days, slight malaise, weakness, headaches and muscle pains, painful sensations in the joints, a slight increase in temperature and mild changes in the lymph nodes and pharynx appear.

Later, there is pain when swallowing. The body temperature rises to 38-40 ° C, it can have a wavy character, such temperature drops persist throughout the day and can last 1-3 weeks. Tonsillitis manifests itself immediately or after a few days, it is catarrhal with mild swelling of the tonsils, lacunar with a more severe manifestation of inflammation in both tonsils or ulcerative necrotic with a fibrinous film as in diphtheria.

A sharp difficulty in breathing and profuse mucous discharge, slight nasal congestion, perspiration and mucous discharge on the back of the pharynx indicate the development of nasopharyngitis. In patients, a spear-shaped plaque can hang from the nasopharynx, there are massive loose, curdled white-yellow overlays on the tonsils.

The disease is accompanied by damage to the angular jaw and posterior cervical lymph nodes, most clearly they swell in the cervical group, along the posterior edge of the sternocleidomastoid muscle in the form of a chain or packet. The diameter of the nodes can be up to 2-3 cm. Less often, axillary, inguinal, and cubital lymph nodes increase.

The infection affects the lymph flow of the intestinal mesentery, causes inflammation, provokes pathological rashes on the skin in the form of spots, papules, age spots. The timing of the appearance of the rash is from 3 to 5 days after three days it disappears without a trace. There is usually no recurrence of rashes.

There is no uniform systematization of the clinical forms of infectious mononucleosis; there can be not only typical (with symptoms), but also atypical (without symptoms) forms of the disease. Histological examination confirms the involvement of several important organs in the process. Inflammation of the interstitial tissue of the lung (interstitial pneumonia), a decrease in the number of cellular elements of the bone marrow (hypoplasia), inflammation of the choroid (uveitis) develop.

The clinical manifestations of the disease are poor sleep, nausea, abdominal pain, diarrhea, and sometimes vomiting. Mononucleosis is characterized by the appearance of intraperitoneal tumors, and it is also associated with the occurrence of lymphatic lymphomas in patients with reduced immunity.

Diagnosis of mononucleosis

Infectious mononucleosis is quite widespread, its mild forms are difficult to diagnose. The peculiarity of this virus is that it prefers to infect the lymphoid tissue, which is in the tonsils, lymph nodes, spleen and liver, therefore, these organs are most affected.

During the initial examination, the doctor determines the main symptoms of the disease based on complaints. If you suspect mononucleosis, a blood test (monospot test) is prescribed, which excludes other diseases that can cause similar symptoms. The accuracy of the diagnosis is possible only with the collection of clinical and laboratory data.

In the blood formula, an increase in lymphocytes and the presence of atypical mononuclear cells in the blood are usually found. Serological studies can identify heterophilic antibodies to the erythrocytes of various animals.

The virus is found in saliva:

• after the incubation period of the infection;
• during its development;
• 6 months after recovery;

Epstein-Barr viruses in a latent form remain in B-lymphocytes and in the mucous tissue of the oropharyngeal membrane. Virus isolation is observed in 10-20% of patients who have suffered infectious mononucleosis in the past. In modern laboratories, laboratory diagnosis of the disease is performed on modern equipment using disposable sterile instruments when sampling biomaterial.

A positive result clarifies the presence of infection in the body, the transition of the disease into a chronic form, as well as the period of activation of the infectious process. Negative results mean no infection early in the course of the disease. A blood test should be done every three days to track the progress of infection.

Consequences of mononucleosis

Complications of infectious mononucleosis are very rare, but if they do, they can be very dangerous. Hematologic complications include increased erythrocyte destruction (autoimmune hemolytic anemia), decreased peripheral platelet count (thrombocytopenia), and decreased granulocyte count (granulocytopenia).

Patients with mononucleosis may experience rupture of the spleen, obstruction of the airways, which is sometimes fatal. There is a danger from a variety of neurological complications - from encephalitis, cranial nerve paralysis, damage to the facial nerve and, as a result, paralysis of the facial muscles. Meningoencephalitis, Guillain-Barré syndrome, multiple nerve damage (polyneuritis), transverse myelitis, psychosis, cardiac complications, interstitial pneumonia are also considered complications of mononucleosis.

After an illness, children usually get tired for about half a year, they need to sleep more, including in the daytime. Such students should be less burdened with classes at school.

Mononucleosis treatment and mononucleosis prevention

In the treatment of mononucleosis, symptomatic therapy is used. During the period of fever, antipyretic agents and drinking plenty of fluids are used. With the help of vasoconstrictor drugs, such as ephedrine, galazolin, etc., relieve the difficulty of nasal breathing.

They use desensitizing drugs that prevent or weaken allergic reactions, interferon, various immunostimulants or other effective antiviral drugs that are in the arsenal of doctors. Patients are prescribed rinsing the throat with warm furacilin solutions, soda solution and salt water.

Ibuprofen, acetaminophen are recommended to relieve headaches and reduce fever. To eliminate pain, reduce swelling of the tonsils, throat and spleen, it is advisable to take corticosteroids, always under constant supervision of the attending physician. Special preventive measures for mononucleosis are the same as for ARVI. An important role is played by increasing immunity and mobilizing the internal forces of the human body.

It is believed that for the treatment of mild and moderate forms of the disease, the patient's stay at rest, that is, bed rest, moderate nutrition. It is necessary to select dietary foods so as not to overload the affected liver. Meals should be fractional (4-5 times a day) with a full content of proteins, vegetable fats, carbohydrates, vitamins.

Therefore, preference is given to dairy products, lean fish and meat, fruits, sweet berries, vegetables and soups from them. You can eat porridge, coarse bread. The child is prohibited from butter, fried, smoked, pickled foods, canned food, pickles, hot seasonings. Walking in the fresh air, a calm, joyful atmosphere in the house, and a good mood will be beneficial.

Regular consultations of a hepatologist will not interfere with the child, it is imperative to be exempt from preventive vaccinations. Hypothermia and overheating, physical activity, playing sports are contraindicated, it is useful to engage in physiotherapy exercises.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".