What antibiotics for infectious mononucleosis in children

Features of the course of mononucleosis in children

The main cause of the disease is the Epstein-Barr virus, which enters the body through everyday objects (plates, towels), and through kisses. Pathology of cytomegalovirus etiology is less commonly diagnosed.

The virus begins to develop on the surface layers of the oropharynx, from where it penetrates the bloodstream and spreads throughout the body through the bloodstream, affecting the heart muscle, lymph nodes, liver and other organs.

Infectious mononucleosis in children is treated under medical supervision

Mononucleosis in children occurs with a pronounced clinical picture. It causes complications only when bacterial or fungal microflora is attached to the background of decreased immunity, manifested in the form of inflammation of the lungs, middle ear, maxillary sinuses or other organs.

The duration of the incubation period depends on the child’s immunity and ranges from 5 days to 3 weeks, after which the acute phase begins (from 2 to 4 weeks), which is accompanied by the development of severe symptoms. In the absence of correct treatment, it becomes chronic, which is characterized by the spread of infection and damage to other organs. After recovery, the child becomes a carrier of the Epstein-Barr virus.

External signs

Local or external symptoms of acute infectious mononucleosis in children are typical:

• damage to the throat in the form of sharp redness, sometimes with a bluish tint;
• enlarged palatine tonsils;
• tonsillitis of various forms, which has a severe, protracted course and cannot be treated with antibiotics;
• plaque appears on the tongue due to impaired self-cleaning;
• small hemorrhages at the border of the hard and soft palate - a characteristic diagnostic sign for the disease;
• stomatitis (simple, ulcerative-necrotic) develops on days 3-4;
• herpetic stomatitis, herpetic rashes on the skin of the face, in the oral cavity;
• enlarged lymph nodes;
• rash.

One of the first symptoms of the disease in children is enlarged lymph nodes. Lymph nodes are dense, multiple, mobile when palpated, painful or moderately painful. The skin over them is not changed in color, there is no swelling. Often, damage to the nodes leads to stagnation of lymph and the development of facial edema - it becomes puffy, the eyelids swell, and sometimes the lips swell. In addition to nearby ones, other more distant parts of the lymphatic system may suffer;

Another characteristic sign is rashes (exanthema). Develop in 10-18% of sick children 5-10 days from the onset of the disease. It looks like spots, papules, and less often, small hemorrhages under the skin. The elements of the rash are located on the face, torso, and limbs. May be accompanied by itching and swelling of adjacent skin areas. The period of existence is 6-8 days.

Infectious mononucleosis in children occurs against the background of significantly suppressed immune properties of the body. The state of the baby’s immunity also affects the frequency and intensity of relapses of the disease. Due to the long asymptomatic incubation period, specific preventive therapy measures are not effective enough, so treatment of mononucleosis in children is predominantly symptomatic.

Forms of mononucleosis in children

Mononucleosis in children can be typical or atypical. The first form is characterized by the development of severe symptoms with fever, inflammation of the tonsils, and enlargement of the spleen and liver. In this case, the growth of a special type of leukocytes - mononuclear cells - is diagnosed in the blood.

An atypical form of a viral infection does not have characteristic signs of the disease. Visceral lesions of the central nervous system, cardiac muscle, and bronchopulmonary system can rarely be diagnosed.

Depending on the severity of the pathology, mononucleosis can be mild, moderate or severe.

Clinical picture of mononucleosis

Symptoms of mononucleosis in children - fever, redness of the throat

After the end of the incubation period, the first symptoms of the disease develop:

• catarrhal manifestations in the form of swelling and redness of the mucous membranes of the nasal passages and oropharynx;
• low-grade body temperature;
• general malaise.

In the acute phase of the pathology, the child’s condition worsens; along with the described signs, the following symptoms begin to worry:

• fever;
• chills;
• dizziness;
• swelling of the face;
• profuse sweating;
• increase in body temperature to critical levels (up to 39°C);
• muscle and headaches;
• insomnia;
• pain and discomfort in the throat, which intensifies when swallowing or talking.

A feature of mononucleosis in children is an enlargement of the occipital, submandibular, and posterior cervical lymph nodes. During palpation, the patient experiences pain and discomfort. The child also develops signs of tonsillitis: swelling and redness of the tonsils, granularity of the surface layers of the oropharynx, pain. When bacterial flora attaches, a white or yellow coating may form.

In adult patients, there is an increase in the size of the liver and spleen.

A characteristic symptom of the disease is a mononucleosis rash, which appears on the 3rd–5th day of the acute period. It consists of spots of pink, red or burgundy color that spread throughout the body. They are not accompanied by itching; its presence indicates an allergic reaction to medications. With proper therapy it goes away on its own.

In addition, it is possible to add symptoms of bronchitis, pneumonia, jaundice, poisoning and other diseases, the development of which depends on the stability of the child’s immunity. Recovery occurs in 2–4 weeks, less often it becomes chronic, which lasts up to one and a half years.

Diagnostics

Diagnosis and treatment of mononucleosis in children is carried out by a doctor; self-medication is dangerous

The difficulty of diagnosis lies in the similar clinical picture with ARVI, sore throat, bronchitis and other diseases. In infancy, the disease is accompanied by symptoms of ARVI with coughing, sneezing, rhinitis and wheezing when breathing. Clinical symptoms are most pronounced in patients aged 6 to 15 years.

To make a diagnosis, a blood test is prescribed.

• General clinical analysis to identify the inflammatory process in the body. With mononucleosis, an increase in ESR, leukocytes, lymphocytes, and monocytes occurs. Atypical mononuclear cells appear in the blood only 2–3 weeks after infection.
• Biochemical analysis to detect the level of sugar, proteins, urea and other indicators by which the functioning of the kidneys, liver and other internal organs is assessed.
• Enzyme immunoassay for mononucleosis to determine antibodies to herpes viruses, the appearance of which helps confirm the diagnosis. It is mandatory and allows you to differentiate mononucleosis and HIV.
• Polymerase chain reaction is used to determine the DNA of pathogens.

If necessary, an ultrasound examination of internal organs is performed before treatment.

Complications

Mononucleosis in children, in the absence of correct therapy and in patients with weak immunity, can cause the following complications:

• rupture of the spleen occurs when there is a sudden change in body position, a blow, or strong pressure during palpation of the abdominal area;
• inflammation of the endocrine glands: thyroid, pancreas, salivary; in boys the testicles are often affected;
• inflammatory processes in the heart muscle and bursa;
• autoimmune pathologies;
• decrease in hemoglobin level in the blood;
• secondary inflammatory processes with the addition of bacterial flora in the bronchopulmonary system, meninges, liver, kidneys and other internal organs;
• autoimmune reactions.

Also, the infectious process increases the risk of the formation of lymphomas - tumors of the lymphatic system with a sharp decrease in immunity.

Most often in medical practice, consequences occur in the form of increased fatigue, so children during the rehabilitation period need long sleep, frequent rest, minimal physical and psycho-emotional stress, as well as a gentle diet.

Treatment of mononucleosis in children

Specific therapy for the pathogen has not been developed, therefore symptomatic and supportive therapy is used.

Treatment is carried out on an outpatient basis. Hospitalization is necessary in case of prolonged fever with a body temperature of 40°C, fainting, severe signs of intoxication, development of complications or asphyxia.

In case of mononucleosis, the use of aspirin is strictly contraindicated, which can accelerate the spread of the virus and the development of complications in the liver and other internal organs.

How to treat the disease:

• antiviral agents with interferon;
• antipyretics with ibuprofen or paracetamol;
• irrigating the throat with solutions containing chlorhexidine, chamomile, furatsilin to relieve pain and have an antiseptic effect;
• antihistamines if signs of allergic reactions appear;
• hepatoprotectors to restore liver function and prevent complications;
• choleretic to prevent liver complications;
• glucocorticosteroids to relieve swelling of the pharynx and prevent asphyxia;
• immunotherapy with nonspecific agents;
• vitamin and mineral complexes to strengthen the immune system;
• probiotics and prebiotics to restore intestinal microflora.

When a secondary bacterial infection occurs and complications develop, treatment is supplemented with antibacterial drugs.

Children need special gentle nutrition during and after treatment

Medicines

Treatment of a disease that is complicated by a bacterial infection is carried out with antibiotics. As a rule, these are drugs from the group of macrolides, which include Vilprafen. The drug has a bactericidal effect and effectively fights intracellular microorganisms, gram-positive and anaerobic bacteria.

For infectious mononucleosis, antibiotics belonging to the aminopenicillin group are not used, because they often cause an allergic reaction, and drugs with an antiallergic effect are not always effective.

Supportive and restorative therapy is required. The patient must adhere to a regime of drinking plenty of fluids. Anti-inflammatory medications will help reduce pain and fever.

You can restore normal intestinal microflora with the help of bifidobacteria. For example, it could be Bifidumbacterin, Linex, etc. Rinse the oropharynx with antiseptic agents in combination with lidocaine solution.

Acetylsalicylic acid is not used for infectious mononucleosis due to the increased risk of developing Reye's syndrome. It is also prohibited to take products containing paracetamol, a substance that negatively affects the liver. It is this organ that is considered the most vulnerable to the development of mononucleosis.

The drug Essentiale normalizes liver activity

To normalize the condition of organs such as the liver and spleen, hepatoprotective drugs and choleretic drugs are prescribed. If there are signs of hypertoxic development of pathology, glucocorticoids (for example, Prednisolone) are required.

Daily routine and nutritional features of mononucleosis in children

During illness, the child must remain in bed with the complete exclusion of physical activity and emotional stress.

Drug treatment can be supplemented with traditional medicine, for example, using chamomile decoction to irrigate the throat, lemon balm leaves to treat a rash, or taken orally for a sedative effect. It is also necessary to follow a special diet. You should exclude canned, spicy, salty, pickled, fatty foods, mushrooms and processed foods, which irritate the intestines and require high energy costs for digestion. The child's diet should include dairy products, cereals, poultry or low-fat fish, vegetable soups, and cereal soups with recycled meat broth. Drinking plenty of fluids is also recommended (water, natural juices and compotes, rosehip infusions, herbal teas).

Recovery period after illness

Those who have recovered from mononucleosis are registered with an infectious disease specialist and a pediatrician. Recovery lasts 3–6 months. Frequent symptoms in a child:

• fatigue;
• poor appetite;
• frequent whims;
• susceptibility to infections.

During rehabilitation after infectious mononucleosis, exposure to sunlight is highly undesirable. Insolation is contraindicated due to the oncogenic activity of the pathogen. Often mononucleosis provokes lymphoma or lymphogranulomatosis if recovery is incorrect.

Articles on the topic

• Consequences of mononucleosis in adults - symptoms and treatment methods
• Mononucleosis in adults - signs, therapy with drugs, folk remedies and diet
• Consequences of mononucleosis in children - how they develop, for what reasons and prevention

The child undergoes routine examinations and is observed by a hematologist. Be sure to take tests: CBC (general blood test), UAM (general urinalysis). According to indications, an ultrasound scan of the liver and spleen may be prescribed. Restoration of the immune system is carried out in the following courses:

1. Vitamin therapy (vitamin and mineral complexes are prescribed).
2. Immunomodulatory drugs (with regular immunogram).
3. Herbal adaptogens (tinctures of ginseng, echinacea, lemongrass).

What to do

After recovery, the baby is regularly brought in for examination.

Scheduled visits to the doctor are needed 1, 3 and 6 months after treatment.

Recovery from mononucleosis includes:

1. Less physical and emotional stress.
2. More time to relax. It is better to sleep 10-11 hours at night, 2-3 hours during the day.
3. Diet. Children should receive important vitamins, minerals, and amino acids.

What not to do

Mononucleosis is a strong “blow” to the immune system and health in general. Strong immunity to infection develops within 2 years. After recovery, doctors do not recommend:

• vaccinations to prevent diseases (12 months);
• load the child with studies;
• visit beach resorts, especially in hot countries;
• often be in the sun;
• go to places with large crowds of people.

Diet to restore immunity

A balanced diet is of great importance for recovery. The baby may refuse to eat and complain of lack of appetite. In order for him to receive the necessary substances, food is divided into 6-7 meals. Small portions will help. Due to this, you will not need to spend a lot of energy on digesting food.

Herpes virus type 4 (Epstein-Barr), which causes mononucleosis, damages lymphoid organs. The diet is designed so that the liver is not overloaded. All drinks and food are served warm. If your baby complains of a sore throat, it is better to grind irritating foods.

The diet includes a lot of proteins, carbohydrates, vitamins, animal and vegetable fats. Include in the menu:

• non-acidic juices from berries and fruits;
• herbal teas;
• rosehip decoction;
• compotes;
• jelly;
• bread of different types, always yesterday’s bread or dried;
• unhealthy cookies;
• milk;
• mild cheeses;
• skim cheese;
• sour cream;
• butter, vegetable oil (up to 25 g per day);
• lean meat (turkey, chicken, beef);
• low-fat fish (cod, carp, pike, silver hake);
• cereals;
• pasta;
• vegetables;
• greenery;
• chicken eggs (no more than 1 per day);
• non-acidic berries and fruits;
• honey;
• sugar.

To prevent relapses during treatment and during the recovery period, limit the following foods:

• fresh bread and pastries;
• soups with strong broths made from meat or fish;
• products made from butter dough (pancakes, cakes, pancakes, pies);
• margarine;
• mushrooms;
• salo;
• sorrel;
• spinach;
• garlic;
• radish;
• mustard;
• green onion;
• pepper;
• radish;
• fatty fish (sturgeon, stellate sturgeon, catfish);
• smoked meats;
• fatty meat (lamb, pork, duck);
• ice cream;
• chocolate;
• cocoa;
• sour fruits and berries;
• pickled vegetables;
• caviar;
• canned food

Prevention of mononucleosis in children

Prevention of the disease consists of strengthening the body’s protective properties through the following measures:

• vaccination in accordance with the vaccination calendar;
• frequent walks in the fresh air;
• moderate physical activity;
• hardening;
• proper nutrition;
• regular cleaning and ventilation of the child’s room;
• preventive examinations by specialists.

Viral mononucleosis is a disease that can occur with severe or mild symptoms. It is characterized by an increase in body temperature, inflammation of the lymph nodes, tonsils and deterioration of the general condition. Treatment is symptomatic and is aimed at destroying pathogenic microflora and relieving signs of the disease.

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Review

Infectious mononucleosis is a viral disease that most often affects children and adolescents. The causative agent of infectious mononucleosis is the Epstein-Barr virus.

Rarer synonyms for infectious mononucleosis are: Filatov's disease, glandular fever, monocytic tonsillitis.

Infectious mononucleosis can affect people at any age, but most cases affect children, adolescents and young adults. In young children, the disease is asymptomatic or mildly unwell. In adults, mononucleosis causes more severe symptoms.

The main signs of infectious mononucleosis can be a temperature of up to 38-40°C, sore throat, swollen lymph nodes in the head and neck, weakness, as well as an enlarged liver and spleen. Sometimes the disease occurs with a rash and jaundice. The disease leaves behind a lasting lifelong immunity.

Infectious mononucleosis is not always easy to distinguish from other infections by external signs, so a blood test is required for diagnosis. In most cases, this is sufficient to confirm the diagnosis. Additional research is rarely required.

In most cases, infectious mononucleosis can be managed within a few weeks at home, following a treatment regimen and taking symptomatic medications. If complications develop, hospitalization in an infectious diseases hospital is possible.

Treatment of mononucleosis with folk remedies

Mononucleosis is not a pleasant disease; it mainly affects children; in adults it occurs more as an anomalous phenomenon. Feverish manifestations can be relieved with steamed chamomile, mint, dill seeds, rose tea, and rosehip decoction. In addition, you should drink tea from raspberry, currant, sea buckthorn, maple, and viburnum leaves, brewed with boiling water, adding honey and lemon to the slightly cooled drink. Thickened honey should not be heated, as this will lose its properties and destroy vitamin C. Rinsing with an infusion or decoction of herbs every hour during treatment will quickly help relieve inflammation and sore throat. Symptoms of intoxication are eliminated by lingonberry juice, linden tea, regular black tea with the addition of honey and lemon juice.

Treatment of mononucleosis with cabbage

In addition to complex treatment, it is recommended to use well-chopped fresh cabbage and a decoction of this vegetable. It is more pleasant and healthier to drink with honey and lemon.

Cabbage decoction: pour washed cabbage leaves, cover with water and cook for 5 minutes over low heat. Let it cool until it cools down and you can take it.

Treatment of mononucleosis with fees

A sick child or adult will recover faster from mononucleosis if they use decoctions from herbs, which include a huge number of different plants, in treatment.

Fees may include:

1. clover flowers, leuzea root, birch buds, alder cones, dandelion root, aerial parts of saussurea and wormwood.

2. the aerial part of the string, yarrow, chamomile, immortelle and calendula flowers, coltsfoot leaves.

3. chicory root or grass, burdock and elecampane root, edelweiss, lactuca, thistle, cornflower flowers.

4. rose hips, raspberry leaf, meadowsweet flowers, bergenia root, currant leaf

5. leaves of fireweed, aerial parts of schizonepeta, mint, violet, blackhead, skullcap root.

6. aerial parts of milkweed, wintergreen, thyme, marina root, geranium, marshmallow and primrose root, wild rosemary shoots.

7. aerial parts of knotweed, mint, motherwort, oregano, yarrow and nettle leaves.

8. immortelle flowers, nettle leaves, birch leaves, dandelion root, aerial part of wormwood and string.

9. chamomile flowers, calendula, coltsfoot leaves, elecampane root, marshmallow, burdock.

10. leaves of currant, raspberry, fireweed, aerial parts of the herb blackhead, violet, mint, volodushka, nettle.

A general recipe for preparing decoctions from the collections: any of the above collections is ground in a meat grinder and mixed. In the evening, take 2 tablespoons of mixed herbal raw materials, pour 1 liter of boiling water and leave in a thermos overnight. In the morning, take the drug 100 milliliters 0.5 before meals. To make the broth more palatable, add honey, sugar, and jam. The course of treatment with the decoction lasts about 2 months; when using it, special drug treatment must be carried out.

There are many more herbs from which infusions are prepared; they can strengthen the body, which is under the influence of toxic attacks during illness.

Infusion No. 1: add 5 tbsp to 0.5 liters of water. l. fruits of mountain ash, hawthorn, leaves of silver birch. 4 tbsp. l. linden flowers, blackberry leaves, lingonberry leaves, marsh grass, black currant leaves. 2 tbsp. l. oat seeds, willow bark. Mix herbal ingredients, 2-3 tbsp. l. Brew the mixture in boiling water, leave to steep for 1 hour, strain. Take a warm infusion 8-10 times a day, 1/4 cup, adding honey and lemon juice to improve the taste.

Infusion No. 2: mix 1 tbsp. spoons of immortelle herb, buckthorn bark, elderberry flowers, St. John's wort herb, knotweed herb. Pour 3 tbsp. l. prepared raw materials 750 ml of water, keep on low heat for 5 minutes. You should drink 3/4 cup of warm broth 20 minutes before meals.

Treatment of mononucleosis with astragalus root

Astragalus is the best remedy against mononucleosis, has powerful antiviral properties, helps cure mononucleosis without side effects.

Astragalus root tincture: pour one tablespoon of roots into a thermos, pour a glass of boiling water and leave for half an hour. Strain and take 1-2 tablespoons 3 times a day before meals.

Astragalus root decoction: pour 6 g of crushed roots with 1 glass of boiling water, keep in a water bath for 15 minutes. Leave covered for 1 hour. Strain, consume 2 tablespoons 3 times a day before meals.

Treatment of mononucleosis with echinacea

Echinacea is widely used for mononucleosis, has antimicrobial and antiviral effects, stimulates the body's defenses, and strengthens the immune system.

Echinacea tea: 3 flowers or 2 teaspoons of crushed root, you can also take Echinacea leaves, brew 0.5 liters of boiling water. Leave to infuse for 40 minutes. You need to drink 3 cups during illness and 1 glass a day to prevent not only mononucleosis, but also other infectious diseases.

Echinacea infusion: 30 g of fresh or dried Echinacea flowers are poured into 0.5 liters of boiling water and boiled for 10 minutes in a sealed container. Leave in a warm place for about 5 hours, strain, add honey and berry syrup. Drink 1/2 cup 3 times a day.

Echinacea decoction: 1 teaspoon of fresh or dry leaves, crushed, brewed in a glass of water in a water bath. After infusion, drink 1/3 cup 3 times a day before eating.

Treatment of mononucleosis with lemon balm

It is known that lemon balm herb, due to its wide range of therapeutic effects due to the content of various biologically active and incredibly useful substances, promotes rapid recovery of the body when affected by the Epstein-Barr virus. The sedative, antispasmodic, immunomodulatory, antihistamine, antioxidant properties of the herb, when taken regularly as tea or decoction, can contribute to good results, and after a week, patients feel much better.

Melissa herb tea: Brew a few lemon balm leaves and stems. Infuse the tea for 10-15 minutes. Drink 2-3 cups a day with honey, preferably warm.

Infusion of lemon balm herb:

1. Pour 20 g of herb into 1 liter of boiling water, leave for one hour and take 1/3 cup 3 times a day.

2. 8 teaspoons of the crushed aerial part of lemon balm are poured with 2 cups of boiling water and left for an hour. The strained infusion is drunk half a glass 3 times a day before meals. You can gargle with this infusion.

Decoction of lemon balm herb: pour 1 tablespoon of dried herb with 1 glass of boiling water, cook in a water bath for 10 minutes, cool, strain through cheesecloth. Drink 1 tbsp. l. 3 times a day before meals. If a rash appears that accompanies mononucleosis, you can wipe the skin of the body with the decoction.

Treatment of mononucleosis with calamus

Calamus is useful in case of difficulty breathing during illness.

Recipe No. 1: 250 ml water and 1 tsp. rhizomes of calamus are poured with boiling water, left for 20 minutes, filtered. Drink the infusion 4 times a day, 0.5 cups, half an hour before meals.

Recipe No. 2: 1 tbsp. l. chopped calamus root, pour 1 cup of boiling water. Boil over low heat for 10 minutes, leave for 2 hours. Take a dessert spoon 5-7 times a day before meals. Drink until relief occurs.

Treatment of mononucleosis with phytoapplications

You need to mix 3 tbsp. l. black currant leaves, birch leaves, mountain arnica leaves, Scots pine buds with 2 tbsp. l. Calendula officinalis flowers, chamomile herb, marshweed herb, melilot officinalis, willow leaves. Brew 5 tbsp. l. mixture with 1 liter of boiling water, leave for 20 minutes. Then carefully drain the infusion, wrap the wet raw material in gauze and apply it to the infected lymph nodes for 15-25 minutes. 8-10 such procedures every other day are enough.

Treatment of mononucleosis with ginger and turmeric root

Drinking ginger tea as a gargle relieves sore throat. Turmeric root has the same effect. Tea recipe: grated ginger and turmeric roots are poured with water and boiled for 10-15 minutes. Cool, strain and drink, adding a little salt or sugar.

Elderberry root. Elderberry is an excellent general tonic, with an effective analgesic and antipyretic effect, and quickly relieves headaches.

Elderberry infusion: 1 tbsp. l. dried elderberry flowers are poured into 1 glass of water and left for 25 minutes, the strained infusion is drunk 5-8 times a day, 2 tablespoons.

Treatment of mononucleosis with golden root

It is advisable to use golden root for secondary bacterial mononucleosis. Tea made from golden root is considered the best remedy for treating mononucleosis in children. There is a rapid improvement in well-being, the natural strength of the body is replenished.

Golden root tea: 1 teaspoon of crushed root is poured into 1.5-2 liters of boiling water. Insist for 1-2 hours. Drink 2-3 times a day, 1-2 glasses at a time.

Mahonia grass

Mahonia root is also called Oregon grape, known as one of the best remedies for mononucleosis. Its berries should be eaten daily; they are an excellent medicine for the liver, the organ that most often suffers from this disease. Improvement will occur within a week with continued use.

Treatment of mononucleosis with dandelion root

Dandelion root has an analgesic effect and purifies the blood during mononucleosis. A decoction of the plant relieves the symptoms of the disease.

Dandelion root decoction: 1 tbsp. spoon of raw material, boil for 1 minute in a glass of water, leave for 1 hour. Strain before use, take 0.5 cups in the morning and evening 30 minutes before meals.

Nutrition during the period of infection should be balanced and healthy. Traditional medicine advises giving weakened children chicken broth with garlic; it helps increase the production of antibodies. By increasing your consumption of bananas, yoghurts and fruit smoothies, you can get rid of the symptoms of mononucleosis. A strict diet, rest, and regular ventilation of the room ease the course of the disease.

Source: Newspaper Healthy Lifestyle, all-Ukrainian newspaper-healer “Granny”

Symptoms of infectious mononucleosis

The first symptoms of mononucleosis appear approximately 1-2 months after infection with the Epstein-Barr virus. The main ones:

• high temperature (fever);
• sore throat - usually much stronger than with a cold or flu;
• enlarged lymph nodes in the neck and possibly in other places, such as under the arms;
• fatigue, weakness.

Infectious mononucleosis can also cause the following symptoms:

• general malaise;
• muscle pain;
• increased sweating;
• lack of appetite;
• pain in the eye area;
• swelling of the tonsils (tonsils) and adenoids (small nodules deep in the nose), which can make breathing difficult;
• redness of the throat;
• small red-purple spots on the palate;
• skin rash;
• swelling under the eyes;
• abdominal pain or bloating;
• yellowing of the skin and whites of the eyes (jaundice).

Most symptoms of mononucleosis go away within 2-3 weeks. A sore throat usually lasts for 3-5 days and then gradually subsides. The temperature usually lasts for about 2 weeks. Fatigue is the most persistent symptom, often lasting for several weeks, and some people experience persistent fatigue for months after other symptoms of the illness have subsided.

Mononucleosis in adults

One study suggests that mononucleosis is less common in people over 40 years of age. Adults may not experience the classic symptoms of mononucleosis—a red throat and swollen glands.

Instead, liver problems may occur. Fever with liver inflammation may make mononucleosis more difficult to detect in this age group. Muscle pain may also be more common in this group.

When should you see a doctor if you have mononucleosis?

Many illnesses cause fever and sore throat, especially colds, flu and common viruses.

Mononucleosis can easily be confused with other diseases , so people are advised to see a doctor if they notice any unknown or concerning symptoms.

The American Academy of Pediatrics advises parents to contact their doctor if their child:

• extremely fidgety or sleepy;
• has a severe headache or sore throat;
• a rash develops for no apparent reason;
• has a constant temperature.

Those who have symptoms of a ruptured spleen should seek emergency care immediately.

Causes of infectious mononucleosis

The causative agent of infectious mononucleosis is the Epstein-Barr virus. In most cases, the Epstein-Barr virus is transmitted through the saliva of an infected person. For example, infection can occur as follows:

The source of infection can be a sick person or a carrier of the virus who does not have symptoms of the disease, but whose saliva contains viral particles. Once in the body, the virus begins to multiply in the oropharynx, penetrates lymphocytes - white blood cells and spreads throughout the body.

Infection with the virus usually occurs during childhood. If this happens before 3 years of age, then the infection occurs hidden, sometimes under the guise of an acute respiratory infection. 45% of those infected over 3 years of age develop symptoms of mononucleosis. By age 35, a person is usually already infected with the Epstein-Barr virus. Therefore, it is extremely rare for the disease to develop in people over 40 years of age.

After recovery, immunity to the virus is developed for life, and the person will never get sick with infectious mononucleosis again. However, the virus remains dormant in the body. Therefore, every infected person can, at certain points in his life, become a source of infection for others.

Risk factor for mononucleosis

Epstein-Barr virus , which causes mononucleosis, is most often transmitted through saliva.

Many people become infected with the virus as children and never notice any symptoms. Once the virus enters the body, it remains there forever, and sometimes it can become active again at a later time.

The reactivated virus can spread to other people through saliva, so a person can get mononucleosis from someone who has no signs of the disease.

The following factors may increase your risk:

• sharing drinks, toothbrushes, or anything that touches the mouth and saliva;
• sexual contact;
• blood transfusion;
• receiving a transplanted organ.

A person whose immune system is compromised has a higher risk of:

• development of symptoms upon first exposure to Epstein-Barr Virus
• reactivation of the virus and causing a second attack of mononucleosis

Mononucleosis is most common between the ages of 15 and 35. Most people will not be infected with it a second time.

Treatment of infectious mononucleosis

There is no specific treatment for infectious mononucleosis. Signs of infection usually subside within a few days. With the help of a treatment regimen and symptomatic remedies, you can alleviate the course of mononucleosis and speed up recovery.

To prevent dehydration, try to drink more fluids (preferably water or sugar-free fruit juices). Do not drink alcohol, as this can harm the liver, which is already weakened by the disease.

To relieve pain, general aches and reduce fever, you can use non-steroidal anti-inflammatory drugs that are sold without a prescription, for example, ibuprofen, paracetamol, etc. Children under 16 years of age should not be given aspirin, as there is a risk of developing a rare but serious disease under called Reye's syndrome. Rinse your mouth regularly with warm salted water to help relieve a sore throat.

With mononucleosis, you need to get more rest, but strict bed rest is not recommended. Staying in bed for long periods of time can aggravate and prolong weakness and fatigue. Gradually increase your activity level as you regain strength, but don't do anything that is difficult for you.

For a month after the onset of the disease, refrain from contact sports and any activities during which you may fall, since mononucleosis is often accompanied by an enlarged spleen and a sudden blow or fall can cause it to rupture.

Quarantine measures are not taken for mononucleosis, since most people are immune to the Epstein-Barr virus. Therefore, you can return to work, college or school as soon as you feel well enough. There is little risk of spreading infection if you follow simple precautions when you are sick, such as not kissing anyone or sharing cutlery. In addition, you must thoroughly wash dishes and other personal items that may contain saliva particles.

Antibiotics do not help with mononucleosis because they do not treat infectious diseases caused by viruses. However, your doctor may prescribe an antibiotic if you notice signs of bacterial complications, such as a sore throat or pneumonia (pneumonia).

For severe infectious mononucleosis, short courses of corticosteroids are used in treatment. For example, if:

• The palatine tonsils have become very enlarged, which interferes with breathing;
• severe anemia (lack of oxygen-carrying red blood cells) has developed;
• signs of pericarditis—inflammation of the heart sac—appeared;
• There are disorders of the brain or nerves, for example, encephalitis.

In severe cases of mononucleosis, inpatient treatment is recommended, that is, hospitalization. Indications for hospitalization may be:

• wheezing (stridor) or difficulty breathing;
• difficulty swallowing liquids;
• severe abdominal pain.

The hospital provides treatment depending on the severity of the condition and the severity of symptoms. This may be the administration of medicinal solutions, antibiotics, corticosteroids intravenously or intramuscularly. In rare cases, surgery to remove the spleen (splenectomy) is required if it ruptures.

Infectious mononucleosis in adolescents

teenage mononucleosis clinic treatment of ESR

Category: For young and expectant mothers

Infectious mononucleosis (mononucleosis infectiosum) is an adenoviral disease accompanied by pronounced changes in the body's lymphatic system. Among the patients, a significant proportion are teenagers. This disease was first described in detail by the prominent Russian pediatrician N.F. Filatov in 1885, then in 1889 by the German doctor W. Pfeiffer, who gave it the name “glandular fever.” The causative agent of mononucleosis is currently identified as the Epstein-Barr virus; it belongs to the group of adenoviruses that are lymphotropic. The pathogen is transmitted by airborne droplets, the source of infection is a sick person, often with an erased form of the disease. The virus penetrates the lymphatic tissue of the nasopharynx and regional lymph nodes (for example, posterior cervical), then spreads hematogenously through the hematopoietic system, causing certain changes in the liver, spleen, and bone marrow. Often the gastrointestinal tract serves as the “gate of entry” for infection, which leads to a pronounced enlargement of the retroperitoneal lymph nodes. When lymphocytes encounter a virus, they absorb it; under the influence of the virus antigen, they turn into a kind of “lymphomonocytes” or immunoblasts, described by N. F. Filatov (Filatov cells). In the affected lymph nodes, liver, spleen, blood and bone marrow of a patient with mononucleosis, these immunoblasts are found in a large number of cases. During the antigen-antibody reaction, various immune disorders develop: dysproteinemia is noted, rheumatoid factor appears, the level of complement (C3 and C4 fractions) decreases, which leads to the accumulation of immune complexes in tissues, increased permeability of the vascular wall and diffuse vasculitis. With complement deficiency, the removal of immune complexes from the body is difficult. Similar changes, including the appearance of “lymphomonocytes,” are also caused by other adenoviruses, which suggests the heterogeneity of infectious mononucleosis, or more precisely, “mononucleosis-like syndrome.” The incubation period is often 5-15 days, during which time patients complain of fatigue, intermittent muscle pain, and headache. Clinic. Typically, infectious mononucleosis begins acutely with sore throat and fever. As a rule, there is pain when swallowing, bright hyperemia of the pharynx, arches of the tongue and looseness of the tonsils. The temperature is increased to 38-39°C from the first days (less often from the end of the 1st week of illness). Weakness and lethargy are usually expressed, and patients have poor appetite. Possible slight rhinitis. In rare cases, abdominal syndrome is observed: bloating, heaviness, unstable stool. Typically, lymphadenopathy is detected from the 1st to 2nd day of illness. Typically, the predominant involvement of the posterior cervical lymph nodes, which reach a size of 2x3 cm, are painful, and moderately mobile. Similar nodes are detected in the area of ​​the sternocleidomastoid muscle. Submandibular, axillary, and inguinal lymph nodes are often enlarged, and less commonly mediastinal and retroperitoneal. As a rule, an enlargement of the liver (1-3 cm from the costal edge) and spleen (2-3 cm below the costal arch) is detected; in mononucleosis, these organs have a soft consistency and are slightly painful. In rare cases, the lymph nodes and spleen have a dense consistency; they remain enlarged for several weeks or even months. Clinical signs of enlarged retroperitoneal lymph nodes are bloating, flatulence, and sometimes loose, frequent stools. In the advanced period of mononucleosis, there is a fever of the wrong type with an increase in temperature to 38-39°C with a distinct decrease in the morning. As a rule, there are no chills. The febrile period ends lytically. At this time, some patients may experience a petechial rash on the skin, nosebleeds and other bleeding due to high fever (with increased vascular permeability and decreased platelet levels). Mild jaundice may occur. In young children, breathing difficulties may occur due to damage to the lymph nodes of the nasopharynx and “false membrane” deposits on the tonsils. It is customary to distinguish 3 variants of the course of infectious mononucleosis - glandular, febrile and anginal, but in most cases it is difficult to determine the variant, because the patient has a combination of sore throat, high fever and lymphadenopathy. The so-called erased (abortive) forms of mononucleosis are characterized by mild sore throat and low-grade fever. Recognizing such a case is especially important from an epidemiological point of view (the danger of spreading infection). The main diagnostic significance for Filatov's disease is changes in peripheral blood . Already from the 2-3rd day of illness, general leukocytosis appears (up to 9000-1.0 000 in 1 μl) due to lymphocytes. On the 6-7th day of the disease, leukocytosis in patients reaches 12,000-20,000, and in some cases - 30,000-50,000. In this case, the main mass of leukocytes (60 to 80%) consists of mononuclear cells - lymphocytes, monocytes, plasma cells . The most important hematological sign of infectious mononucleosis is the appearance of altered mononuclear cells - atypical mononuclear cells, which, according to their cytochemical and morphological characteristics, can belong to both lymphocytes and monocytes. These are immunoblasts that arise from lymphocytes under the influence of a virus. The number of Filatov cells in the blood formula can range from 10 to 70%; there are many of them in bone marrow. The level of red blood cells and hemoglobin, as a rule, does not decrease. Throughout the illness, ESR is normal or slightly elevated (up to 20-30 mm per hour). As a rule, the level of platelets decreases slightly (to 180,000-150,000 in 1 μl), which is explained both by the direct effect of the virus and by the increased destructive function of the enlarged spleen (hypersplenism). The disease usually lasts 1-3 weeks, during which time the sore throat disappears and the body temperature normalizes, however, enlargement of the lymph nodes, spleen and “lymphocytes” in the blood can persist for months. In rare cases, complications such as myocarditis, glomerulonephritis, encephalitis, meningitis, otitis (especially in young children), swelling of the pharynx and larynx, which threatens asphyxia, are observed. It has been proven that these complications are of an immunocomplex nature; they are essentially diffuse vasculitis. Cases of the transition of infectious mononucleosis to lymphogranulomatosis have been described. The diagnosis of infectious mononucleosis is made on the basis of characteristic lymphadenopathy (painful posterior cervical lymph nodes) and the appearance of Filatov cells in the blood. The diagnosis is confirmed by sternal puncture: the composition of the bone marrow includes lymphocytes, monocytes and plasma cells. There are no more than 2% of power cells; they have no signs of atypia. The number of megakaryocytes is normal. In rare cases, lower lymphography is prescribed for diagnostic purposes - contrasting of the peritoneal lymph nodes. Serological reactions. From the end of the 1st week of illness, patients have a positive Paul-Bunnell reaction with a titer of 1:64 or higher, i.e., antibodies to sheep or rabbit red blood cells appear in the patients’ blood. In this case, the antigens of sheep erythrocytes are similar to the antigen of the mononucleosis virus. The Paul-Wunnell reaction is positive until the end of the 3rd week of illness, i.e. and after the subsidence of acute catarrhal phenomena. However, this reaction is sometimes positive also with influenza, with other adenoviral diseases and with viral hepatitis. Note that a negative result of the Paul-Wunnell test does not yet allow us to deny mononucleosis. The agglutination reaction of horse erythrocytes in the presence of serum from a patient with mononucleosis (Hoff-Bauer reaction) is more specific, in addition, it is positive from the 1st day of illness. The Tomczyk reaction is also used (agglutination of bovine red blood cells treated with trypsin in the patient's serum). Differential diagnosis is not always easy. Almost first of all, it is most important to exclude tumor diseases of hematopoiesis - leukemia and lymphogranulomatosis. Acute leukemia can often also begin with a sore throat, enlarged lymph nodes, spleen and liver, and thrombocytopenia. However, in acute leukemia, the level of platelets is usually lower (20,000-40,000 in 1 μl and below), and the hemoglobin content is also reduced. In the bone marrow, and sometimes in the peripheral blood, a significant number of powerful cells are detected - with a “young” delicately structured nucleus, with nucleoli, and a light, narrow cytoplasm. There are few normal cells in the bone marrow - granulocytes, megakaryocytes (“depression of hematopoiesis”). Let us remember that tonsillitis in acute leukemia is necrotic, not catarrhal. Within 1-2 weeks with acute leukemia there are no signs of convalescence; on the contrary, fever and sore throat increase, stomatitis, hemorrhagic syndrome may appear, and pneumonia is often associated. With lymphogranulomatosis, the nodes are dense, slightly painful, progressively enlarged, lymphocytopenia is usually observed in the blood, and the ESR is increased. The diagnosis is confirmed by histological examination of the lymph node (presence of Berezovsky-Sternberg cells). Chronic leukemia does not have an acute onset, occurs against the background of uniform lymphadenopathy, the liver and spleen are large, dense, and painless. In all doubtful cases, the patient should be referred to a hematologist or oncologist, who will make a diagnosis using a morphological examination of blood smears, bone marrow, and, if necessary, a lymph node biopsy. It is advisable that all blood smears of the patient be retained for retrospective evaluation. Without morphological confirmation of the diagnosis, it is impossible to begin treatment of the patient with such strong and dangerous drugs as prednisolone and cytostatics (6-mercaptopurine, etc.). With influenza, the submandibular and other cervical lymph nodes can reach a size of 2-3 cm and acquire significant density. In such cases, a histological examination of the lymph node after a biopsy performed by a surgeon is mandatory. With influenza, the nodes are enlarged symmetrically, they are moderately painful, there is no anemia, thrombocytopenia, the spleen is not enlarged. There is moderate leukopenia in the blood. In the first 4-5 days, the clinical picture of Filatov’s disease may resemble typhoid fever, but in the latter case, continuously increasing intoxication and a “Botkin-type” temperature curve are observed (alternating 4-5-day periods of high temperature with periods of lower temperature); in other cases, with typhoid fever, the temperature rise occurs in steps with a constantly high temperature during the peak period and a gradual decrease in the future (Wunderlich curve). Patients experience relative bradycardia (i.e., the pulse rate lags behind the temperature), decreased blood pressure, and signs of intestinal damage, which does not happen with infectious mononucleosis. In the peripheral blood of typhoid fever, from the 4th-5th day, leukopenia and a significant increase in ESR are observed, and on the 7th-8th day a characteristic roseola rash appears. With the toxic form of diphtheria, enlargement of the liver and spleen is possible, sore throat is pronounced, but mainly the submandibular and lateral cervical (and not the posterior cervical!) lymph nodes are affected. In the pharynx, dirty filmy deposits are identified, in which Leffler's bacillus can be identified bacterioscopically. Other peripheral lymph nodes, with the exception of the cervical ones, never enlarge. With tularemia, lyphadenitis is detected only in the area of ​​the “entrance gate” of the infection (bubonic or anginal-bubonic form), only one tonsil is affected, and lymphadenopathy is also unilateral. The nodes are painless; later they are opened with the release of creamy pus. In this case, a thorough analysis of the epidemiological situation is of great importance. The diagnosis of tularemia can be confirmed by seroreactions (skin allergy test with tularin), which become positive from the 5th to 7th day of illness. With endemic lymphadenitis, which occurs, for example, in Stavropol, patients also have enlarged cervical lymph nodes, they are dense, painful, mobile and their size ranges from 1 to 7-8 cm. The onset of the disease is acute, but without sore throat and fever, the course is benign . It is characteristic that leukocytosis, blood count and ESR are normal. Diagnosis of the disease is based on clinical and epidemiological data. An increase in the posterior cervical and occipital lymph nodes (up to 2-3 cm) is also observed with rubella. The glands are dense, their palpation is painful. Tuberculous lymphadenitis is a one-sided process, the submandibular and supraclavicular lymph nodes are more often affected, they have a dense elastic consistency, are slightly painful, and when they decay caseously, fistula tracts appear. The primary focus in this case, as a rule, is located in the tonsils, less often in the gums. The diagnosis of tuberculous lymphadenitis is confirmed by the detection of Pirogov-Langhans cells in the tissue of the lymph node by a positive Mantoux test. In most cases, treatment for infectious mononucleosis is not required. Typically, patients are not hospitalized, but isolated for 2-3 weeks at home. Semi-bed rest, pureed food, and plenty of fluids are prescribed. It is recommended to gargle with disinfectant solutions (furacilin 1:10000, rivanol 1:100), and take amidopyrine or analgin up to 0.25-0.5 g (for analgesic purposes). Physiotherapy is contraindicated. In case of severe intoxication (weakness, fever), massive overlays on the tonsils, significant enlargement of the liver and spleen, concomitant anemia, rheumatism, pyelonephritis and other diseases, hospitalization is required. In the hospital, such patients are prescribed antibiotics (penicillin 400,000 units 6 times a day, ampicillin 0.25 g 4 times intramuscularly, tetracycline, etc.), multivitamins, intravenous infusions of glucose solutions, cardiac glycosides, etc. In severe cases Inpatients are prescribed prednisolone 10-15 mg per day for 5-10 days. You should remember the need for medical supervision (for 15-30 days) of persons with whom the patient with infectious mononucleosis came into contact at work, at school or at home. Usually, those who have recovered from the disease have lifelong immunity; occasionally, relapses of mononucleosis are possible, apparently caused by a different strain of the virus. We emphasize that in adolescents who have had Filatov’s disease, changes in the lymph nodes, liver and spleen remain for quite a long time, and sometimes the level of transaminases remains elevated for a long time. All this indicates the depth of viral damage to organs and tissues in infectious mononucleosis and the need for certain preventive measures in relation to secondary pathology. These include adherence to diet No. 5, which spares the liver (for a period of at least 6 months), a rational regime of work and rest, and the absolute exclusion of alcohol.

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Complications of infectious mononucleosis

Most people with infectious mononucleosis recover within 2 to 3 weeks and do not experience any further health problems. However, in some cases complications may develop. Some of the main complications of mononucleosis are described below.

Prolonged fatigue occurs in more than 10% of mononucleosis cases. Loss of energy may last more than 6 months after infection. Some experts believe it may be a form of chronic fatigue syndrome. It is a poorly understood condition that causes constant fatigue and a range of other symptoms such as headaches and joint pain.

Reduction in the number of blood cells. In rare cases, mononucleosis can lead to changes in the blood, namely a reduction in the amount of:

• red blood cells (anemia) - may cause fatigue and shortness of breath;
• neutrophils - white blood cells (neutropenia) - may increase the risk of secondary infection;
• platelets - this makes bruising easier and bleeding lasts longer.

In most cases, blood count abnormalities are temporary and go away within a few months without causing serious symptoms.

Splenic rupture is a rare and dangerous complication of mononucleosis. The risk of a ruptured spleen is very small, occurring in only 1 in 500 to 1000 cases of mononucleosis, but a ruptured spleen can cause death due to severe internal bleeding. The main symptom of a ruptured spleen is acute pain in the left abdomen. In this case, you need to call an ambulance by calling 03 from a landline phone, or 911 or 112 from a mobile phone. In some cases, emergency surgery to remove an enlarged or ruptured spleen (splenectomy) may be required.

A ruptured spleen typically occurs when damage is caused by intense physical activity, such as playing contact sports. Therefore, it is necessary to refrain from such activity for at least a month after the onset of symptoms of infectious mononucleosis. Be especially careful during the second and third weeks of illness, as the spleen is most vulnerable during this period.

About half of people with mononucleosis have an enlarged spleen. This in itself does not pose a health threat.

Neurological complications. In less than 1% of cases, the Epstein-Barr virus can affect the nervous system and provoke the development of a number of neurological diseases:

• Guillain-Barré syndrome is damage to peripheral nerves that causes numbness and weakness in the limbs, flaccid paralysis.
• Facial paralysis (Bell's palsy) is temporary paralysis of one half of the face.
• Viral meningitis is an infectious disease that affects the protective lining of the brain and spinal cord. Viral meningitis is usually milder than bacterial meningitis, which can be fatal.
• Encephalitis is an infectious disease of the brain.

These complications often require special treatment, but in more than 80% of cases, people make a full recovery.

Secondary infection. Secondary bacterial infections usually occur in people with weak immune systems, such as people with AIDS or people undergoing chemotherapy. In them, mononucleosis weakens the body so much that it becomes vulnerable to bacteria. With infectious mononucleosis, severe secondary infectious diseases such as pneumonia (infectious disease of the lungs) and pericarditis (infectious disease of the heart sac) can occur.

If you are immunocompromised and contract mononucleosis, you may be admitted to hospital for treatment under specialist supervision as a precaution. This way, doctors can closely monitor your health and treat secondary infections if they arise.

When to see a doctor for infectious mononucleosis

If you think you or your child has mononucleosis, contact your general practitioner or pediatrician. Using the NaPopravka service, you can also find a good infectious disease specialist - a specialist who also diagnoses and treats mononucleosis.

If you are offered hospitalization, you can choose a reliable infectious diseases hospital for full treatment of mononucleosis.

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Seven most common myths

Infectious mononucleosis is a benign disease characterized by fever, enlarged lymph nodes, sore throat, nasal voice, enlarged liver and spleen. In a blood test during MI, leukocytosis and lymphocytosis are observed, and atypical mononuclear cells are often detected. If a patient with mononucleosis is prescribed antibiotics based on amoxicillin or ampicillin, a rash similar to urticaria may occur. Considering that patients with MI are characterized by high fever and inflammation of the tonsils, it is necessary to carry out a differential diagnosis with adenoviral infection and streptococcal sore throat.

Most often, infectious mononucleosis is caused by the Epstein-Barr virus (EBV, human herpes virus type 4) (95% of cases), less often by human herpes virus type 6 (HHV-6) and cytomegalovirus (CMV). The Epstein-Barr virus is omnipresent, and sooner or later the majority of the world's population is infected with it. EBV is transmitted through saliva, which means that from birth a child can get it from kissing parents and relatives. By the age of 3, about 80% of children have already encountered this virus.

But EBV infection does not mean that the patient will experience mononucleosis. Most people, after contact with EBV, become ill asymptomatically or in an acute respiratory infection-like form.

After infection, EBV does not disappear from the body, but remains to live in a person forever in a dormant state. In this regard, the virus can be detected in saliva and even in blood throughout life, which is recognized as normal and is not a sign of an acute disease.

Well, now the common myths that poison the lives of patients and their parents.

In no case. Although most often MI is not a mild disease, in the vast majority of cases it goes away on its own, with symptomatic treatment. Sometimes, when a bacterial infection occurs, antibiotics are required. Complications are extremely rare.

Indeed, EBV is a type 4 herpesvirus. Theoretically, it may be affected by acyclovir drugs. But no international studies have proven their effectiveness in myocardial infarction. Moreover, it is believed that the clinical manifestations of MI are associated not with the actual replication of the virus, but with the immunopathological reactions it triggers. Thus, the prescription of antiviral drugs for MI is virtually pointless, especially interferons - drugs that are actively used for the treatment of MI only in Russia and the CIS countries.

This is complete nonsense. There is not a single study showing the dangers of the sun after mononucleosis. This disease occurs all over the world, including in Spain, Italy, Africa and South America, where there is much more sun than in Russia. Have you heard about the flow of foreigners who, after suffering from mononucleosis, are hiding in Murmansk?

Another question is that too much sun can be harmful for any person; you should not overuse tanning.

Not a single instruction for any vaccine states that vaccination can be done only 6 months after MI. Moreover, this is absolutely contrary to common sense - if the patient is weakened after an illness, it means that he is more likely to contract any infection. So what is safer if you have a weakened immune system - to get vaccinated with a modern harmless vaccine or to get sick with a new evil disease? In my opinion, the answer is obvious.

As for sports, there are no clear deadlines. We really do not recommend playing sports until your health returns to normal, ALT levels in the blood are restored and until the spleen decreases (risk of rupture). That is, it all depends on the severity of the disease: if the mononucleosis was not severe, there are no restrictions; if there was reactive hepatitis (high ALT) and/or there was severe splenomegaly, we are waiting for these indicators to normalize.

After an MI, EBV remains in the body for life. This means that it can continue to be identified for a very long time—in fact, for the rest of your life. There is no point in using such tests to monitor a previous MI.

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Antibiotics are not used to treat viral diseases. Almost everyone already knows this. However, quite often you may encounter the fact that antibiotics are prescribed for mononucleosis. Why is this type of medication prescribed for this disease caused by a herpes virus?

Infectious mononucleosis Performed by: Polina Cherepanova, student 381 “m” - presentation

Infectious mononucleosis Completed by: Polina Cherepanova, student 381 "m"
Infectious mononucleosis (mononucleosis infectiosa, Filatov's disease, monocytic tonsillitis, benign lymphoblastosis) is an acute viral disease that is characterized by fever, damage to the pharynx, lymph nodes, liver, spleen and peculiar changes in blood composition. (mononucleosis infectiosa, Filatov's disease, monocytic tonsillitis, benign lymphoblastosis) is an acute viral disease characterized by fever, damage to the pharynx, lymph nodes, liver, spleen and peculiar changes in blood composition.

History N.F. Filatov (1895), was the first to draw attention to a febrile disease with enlarged lymph nodes and called it idiopathic inflammation of the lymph glands. The described disease for many years bore his name Filatov's disease. N.F. Filatov (1895) was the first to draw attention to a febrile disease with enlarged lymph nodes and called it idiopathic inflammation of the lymph glands. The described disease for many years bore his name Filatov's disease. In 1889, the German scientist E. Pfeiffer described a similar clinical picture of the disease and defined it as glandular fever with damage to the pharynx and lymphatic system. In 1889, the German scientist E. Pfeiffer described a similar clinical picture of the disease and defined it as glandular fever with damage to the pharynx and lymphatic system.

With the introduction of hematological research into practice, characteristic changes in blood composition in this disease were studied, according to which American scientists T. Sprent and F. Evans called the disease infectious mononucleosis. With the introduction into practice of hematological research, characteristic changes in blood composition in this disease were studied, according to which American scientists T. Sprent and F. Evans called the disease infectious mononucleosis. In 1964, M.A. Empstein and I. Barr isolated a herpes-like virus from Burkitt's lymphoma cells, named after them the Empstein-Barr virus, which was later found with great consistency in infectious mononucleosis. In 1964, M.A. Empstein and I .Barr was isolated from Burkitt's lymphoma cells, a herpes-like virus named after them Empstein-Barr virus, which was later found with great consistency in infectious mononucleosis.

Epidemiology The source of infection is a sick person, including those with erased forms of the disease, and the virus carrier. The source of infection is the sick person, including those with erased forms of the disease, and the virus carrier. The pathogen is transmitted from a sick person to a healthy person by airborne droplets, most often with saliva (for example, when kissing, hence the name “kissing disease”, when using shared dishes, linen, bed, etc.), transmission of the infection is possible through blood transfusion .The pathogen is transmitted from a sick person to a healthy person by airborne droplets, most often with saliva (for example, when kissing, hence the name “kissing disease”, when using shared dishes, linen, bed, etc.), transmission of infection is possible through transfusion blood. Overcrowding and close quarters of sick and healthy people contribute to infection, which is why outbreaks of the disease are common in dormitories, boarding schools, camps, and kindergartens. Overcrowding and close quarters of sick and healthy people contribute to infection, which is why outbreaks of the disease are common in dormitories, boarding schools, camps, and kindergartens.

Etiology The causative agent is a DNA genomic virus of the genus Lymphocryptovirus of the subfamily Gammaherpesvirinae of the family Herpesviridae. The causative agent is a DNA genomic virus of the genus Lymphocryptovirus of the subfamily Gammaherpesvirinae of the family Herpesviridae. The virus is able to replicate, including in B lymphocytes; unlike other herpes viruses, it does not cause cell death, but, on the contrary, activates their proliferation. The virus is able to replicate, including in B lymphocytes; unlike other herpes viruses, it does not cause cell death, but, on the contrary, activates their proliferation.

Virions include specific antigens: capsid (VCA), nuclear (EBNA), early (EA) and membrane (MA) antigens. Each of them is formed in a certain sequence and induces the synthesis of corresponding antibodies. In the blood of patients with infectious mononucleosis, antibodies to the capsid antigen first appear, and later antibodies to EA and MA are produced. The pathogen is not stable in the external environment and quickly dies when dried out, under the influence of high temperature and disinfectants. Virions include specific antigens: capsid (VCA), nuclear (EBNA), early (EA) and membrane (MA) antigens. Each of them is formed in a certain sequence and induces the synthesis of corresponding antibodies. In the blood of patients with infectious mononucleosis, antibodies to the capsid antigen first appear, and later antibodies to EA and MA are produced. The pathogen is not stable in the external environment and quickly dies when it dries out, under the influence of high temperature and disinfectants.

The incubation period can be up to 21 days, usually about a week. The illness period of up to two months can reach up to 21 days, usually about a week. Illness period up to two months

Symptoms weakness weakness mucus in the lungs mucus in the lungs frequent headache, migraine, dizziness frequent headache, migraine, dizziness pain in muscles and joints (most often from the pressure exerted by the lymph nodes; the larger the node, the greater the pressure can be exerted on the nerves endings) pain in muscles and joints (most often from the pressure exerted by the lymph that has formed the nodes; the larger the node, the greater the pressure can be exerted on the nerve endings)

increased body temperature (as a result - increased sweating) increased body temperature (as a result - increased sweating) sore throat when swallowing (tonsillitis) sore throat when swallowing (angina) inflammation and enlargement of the lymph nodes (without drug intervention during the course of the disease throughout over a long period of time (several months/years), there is not only a qualitative increase in already inflamed lymph nodes, but also an increase in their number, for example, a sluggish transformation of one node into a chain of three) inflammation and enlargement of the lymph nodes (without drug intervention during the course of the disease for a long time period of time (several months/years) there is not only a qualitative increase in already inflamed lymph nodes, but also an increase in their number, for example, a sluggish transformation of one node into a chain of three) enlargement of the liver and/or spleen enlargement of the liver and/or spleen

appearance in the blood of atypical mononuclear cells, an increase in the proportion of mononuclear elements (lymphocytes, monocytes) appearance in the blood of atypical mononuclear cells, an increase in the proportion of mononuclear elements (lymphocytes, monocytes) increased sensitivity to ARVI and other respiratory diseases increased sensitivity to ARVI and other respiratory diseases frequent skin lesions Herpes simplex virus (“herpes simplex”, or herpes virus type 1), usually in the area of ​​the upper or lower lip; frequent skin lesions with the Herpes simplex virus (“herpes simplex”, or herpes virus type 1), usually in the area of ​​the upper or lower lip lower lipHerpes simplex virusHerpes simplex virus

Complications Otitis Otitis Paratonsillitis Paratonsillitis Sinusitis Sinusitis Pneumonia Pneumonia Rarely: splenic rupture, acute liver failure, acute hemolytic anemia, neuritis. Rarely: splenic rupture, acute liver failure, acute hemolytic anemia, neuritis.

Treatment Specific therapy has not been developed. Specific therapy has not been developed. Treatment is symptomatic, restorative. Treatment is symptomatic, restorative. Due to the risk of splenic rupture, it is recommended to limit physical activity in the first 1-1.5 months. Due to the risk of splenic rupture, it is recommended to limit physical activity in the first 1-1.5 months. To reduce the temperature, it is better to use paracetamol, since the use of aspirin can provoke Reye's syndrome. To reduce the temperature, it is better to use paracetamol, since the use of aspirin can provoke Reye's syndrome. Antiviral treatment acyclovir tablets 0.1 (children under 3 years old), 0.2 (over 3 years old) 5 times a day or cycloferon according to the scheme. Antiviral treatment acyclovir tablets 0.1 (children under 3 years old), 0.2 (older 3 years) 5 times a day or cycloferon according to the scheme. It is recommended to dress warmly. It is recommended to dress warmly.

When are antibiotics needed to treat mononucleosis?

Mononucleosis is an infectious disease caused by a virus. When treating viral diseases, antiviral drugs and symptomatic treatment are used.

The main treatment of infectious mononucleosis should also be aimed at eliminating the characteristic symptoms:

• antipyretic drugs (not based on acetylsalicylic acid);
• antiseptics (to relieve sore throat);
• antihistamines (to relieve throat swelling and other allergic manifestations);
• drugs to strengthen the immune system and vitamins.

Antibiotics for mononucleosis in adults and children are necessary to treat a bacterial infection that develops against the background of the underlying disease and occurs with reduced immunity.

Only a qualified doctor can determine the presence of secondary bacterial infection. Sometimes a visual inspection is enough for this. But you may need to do a throat swab and other tests to detect atypical mononuclear cells.

Infectious mononucleosis itself is not an indication for the use of antibiotics. You should not start taking these medications after diagnosis.

Uncontrolled treatment with antibiotics is contraindicated for the following reasons:

Infectious mononucleosis: incubation period, symptoms (rash, lymph nodes, sore throat)

Antiviral drugs for mononucleosis

There is currently no specific cure for mononucleosis, nor is there any specific treatment. Immunostimulants have not shown effectiveness. In this regard, treatment consists of relieving symptoms and preventing the development of complications.

In some cases, pediatricians prescribe antiviral drugs for mononucleosis, such as:

• Acyclovir;

• Groprinosin.

Immunostimulating drug Groprinosin with antiviral effect in tablets

Antibiotics for mononucleosis

Since mononucleosis is a viral infection, it cannot be treated with antibiotics. At the same time, the disease may be accompanied by complications caused by bacterial infections. In this case, doctors may prescribe antibiotics.

If there are no bacterial complications due to mononucleosis, then taking antibacterial agents is not necessary.

Important! Antibiotics such as Ampicillin and Amoxicillin cannot be prescribed in this case; they are contraindicated for mononucleosis. If they are taken for this disease, it will lead to a rash on the body that will last a very long time (up to several months).

Temperature during mononucleosis in children

One of the first and main symptoms of infectious mononucleosis is an increase in body temperature. In this case, the temperature can reach up to 40 degrees.

Increased temperature in a child with mononucleosis

As in other cases, it is recommended not to lower the temperature below 38-38.5 degrees. It is necessary to give the body the opportunity to cope with the infection on its own.

However, if the temperature remains above 38.5 degrees for a long time and continues to rise, you should give the child an antipyretic:

• Ibuprofen;
• Nurofen;
• Paracetamol.

Important: Do not give your child aspirin to lower the temperature. This drug is contraindicated in children, as it can cause severe damage to the liver and brain. Aspirin can also cause Reye's syndrome.

Mononucleosis without fever

Mononucleosis occurs quite often without a clear hallmark of the disease - high body temperature. This happens when the disease is asymptomatic, because of this, many people do not even know that they were sick.

Mononucleosis rash

With infectious mononucleosis, there may be a rash on the body in the form of small red dots. The rash is accompanied by fever, but the rash does not itch and does not require medication. When the child recovers, the rash disappears.

Some antibiotics can also cause a rash. This rash will be different, and the rash will remain on the body for a long time.

How to find out about a secondary infection

The entry of the pathogen (Epstein-Barr virus) into the body and the onset of the development of infectious mononucleosis negatively affects the general condition of the immune system. It becomes unable to fight other infections. Therefore, very often a secondary infection begins to develop.

Most often, secondary infection is presented by:

• staphylococci;
• streptococci;
• pneumococci;
• Pseudomonas aeruginosa;
• fungal infections.

Secondary infection leads to the following complications:

1. Inflammation of the pharyngeal tonsils (leads to the development of adenoiditis and inflammation of the middle ear).
2. Inflammation of the palatine tonsils (leads to the development of tonsillitis in catarrhal, lacunar or follicular form).
3. Inflammatory process in the nasal cavity (leads to the development of purulent rhinosinusitis).
4. Pneumonia.

The secondary infection makes itself felt on the 3-4th day of the course of the main disease. It may not be easy to recognize. To do this, it is important to monitor any changes in the child’s condition. The tonsils become covered with a characteristic coating, and their size increases significantly. Breathing becomes difficult. Plaque can spread to the entire oral cavity.

One of the characteristic signs of an additional infection is purulent discharge. This is especially noticeable with purulent rhinosinusitis, as pus begins to be released along with normal mucus.

Treatment of Epstein-Barr virus (EBV) in children and adults, duration and treatment regimen for EBV

Why does the temperature rise during mononucleosis?

The infection is transmitted through saliva and other secretions of a sick person. Having secured itself on the surface of the mucous membrane of the mouth, nose or other organs, the virus penetrates epithelial cells. From there, the infection moves to the salivary glands.

Infectious disease specialists note the cyclical course of mononucleosis with clearly defined stages. From the moment of infection to the appearance of the first symptoms, 20-40 days pass. During this period, new cells become infected, and the virus multiplies and accumulates.

The human immune system responds to the accumulation of infectious units by synthesizing a large number of killer T cells. These immune cells destroy other cells in the body that have already been infected by the virus. As a result, when cells disintegrate, many biologically active substances enter the blood. Their circulation and impact on the temperature center in the brain (hypothalamus) causes an increase in temperature in mononucleosis.

But fever is not the only sign of illness. In addition to fever, the Epstein-Barr virus provokes changes in the structure of the liver. They arise due to damage to the organ by toxins. It is at this time that other symptoms of the disease begin to appear: lethargy and weakness, swollen lymph nodes, sore throat and herpetic sore throat.

What antibiotics are used for mononucleosis

Antibiotics are not one universal type of drug. They are divided into several groups, depending on what type of bacteria they are able to fight. There are also broad-spectrum antibacterial agents. They are prescribed if the causative agent of the infection has not yet been identified, but treatment must be started urgently.

When treating mononucleosis in children and adults, the following antibacterial agents may be prescribed:

Sumamed and Cefazolin