The disease proceeds with fever, swollen lymph nodes and spleen. If the immune system is strong, then infectious mononucleosis passes faster or does not manifest in any way. The virus is in the lymphocytes of the human body in a latent state.

Pathogens and forms of infectious mononucleosis

Until the modern term, the disease was called glandular fever. Pathogenic virions were discovered in the experiments of Epstein and Barr, received the name in honor of scientists. Infectious mononucleosis (MI) is a polyetological disease in the development of which several types of viruses take part.

Causative agents of MI

The cause of mononucleosis is infection with human herpes viruses of types 4, 5, 6 (HHV-4, 5, 6). In addition to numbers, individual names are used. HHV-4 - Epstein-Barr gamma herpes virus (EBV, EBV). HHV-5 - cytomegalovirus (HCMV, CMV). HHV-6 - herpesvirus type 6 (HHV-6).

The incubation period for EBV is about 1–7 weeks (from 7 to 50 days), for cytomegalovirus - from 20 to 60 days. Strong immunity can extend the period from introduction to the active reproduction of viruses for 1-2 months or longer.

The life cycle of pathogens begins in the mucosa of the oral and nasopharynx. V-cells that respond to EBV turn into abnormal cells (atypical). Increased activity of viruses is accompanied by the appearance of many infected lymphocytes.

Acute, atypical, chronic myocardial infarction

The infection does not manifest itself in the latent state of the virus (asymptomatic carriage). Easy flow is a feature of mononucleosis infection in children under 10 years old. The acute form can be cured in 2-3 weeks.

Mild and moderate fever for a long time is one of the features of the atypical form. The patient suffers from recurrent respiratory infections, gastrointestinal tract. Chronic MI lasts over 3 months. In this case, the risk of superinfection and other complications increases. The peak of detected cases of atypical and chronic diseases occurs in adolescence and youth. Older people are less likely to get sick.

Ways of infection

Among adults, 90% are carriers of MI pathogens. Viruses are transmitted in several ways. Airborne infection predominates. In addition, viral particles can be stored on dishes, toys, underwear. The causative agent is transmitted with particles of saliva and other biological fluids, which occurs when sneezing, coughing, kissing, sexual intercourse.

Viruses can be released in all forms, even with asymptomatic infection.

The fetus becomes infected inside the womb, the newborn - during childbirth, the infection is transmitted to the baby through breast milk. Other ways are related to blood transfusion, organ transplantation.

ICD-10 disease code

In the International Statistical Classification, the coding of MI is carried out by pathogens. Infectious mononucleosis is assigned a code for ICD-10 - B27, including diseases caused by gamma herpes viruses - B.27.01, cytomegaloviruses - B27.1. The code for MI caused by type 6 herpes viruses and other pathogens is B27.8 and 9.

Symptoms and signs in adults and children

Changes in the health status of an infected person are caused not only by the activity of viruses. As has been proven in numerous studies, the symptom complex is largely dependent on the strength of the response of the immune system. More vivid signs of infectious mononucleosis appear in adults and adolescents who first became infected with HHV-4, 5, 6. There is an inexplicable fatigue that accompanies the patient for several weeks.

Three main signs of acute mononucleosis infection: fever, pharyngitis, lymphadenopathy.

The temperature reaches maximum values ​​in the afternoon or evening (from 39.5 to 40.5 ° C). A grayish or yellow-white plaque appears on the throat mucosa. The main symptom of MI is swelling of the lymph nodes in the neck, under the armpits. The stronger the immune system resists, the brighter the signs of a viral disease. There is an increase in the size of the spleen (splenomegaly), liver. Red itchy spots and papules appear on the face, hands, body.

The acute form of infectious mononucleosis in children occurs as a cold, ARVI, tonsillitis. Lymph nodes swell and become painful, a burning sensation appears in the throat. The condition of the child worsens in the evening. Jaundice is noted when a viral infection spreads to the liver. Teenage patients may suffer from leg pain.

What diseases can be confused with infectious mononucleosis?

The patient feels discomfort in the throat for several days as with pharyngitis or tonsillitis. A rash with infectious mononucleosis is similar to urticaria, allergic dermatitis. The response of the immune system may be the same, although the reasons are different. Differential diagnosis is needed to exclude similar diseases.

There are common symptoms of the disease with other infections:

  • streptococcal pharyngitis;
  • bacterial tonsillitis;
  • primary HIV infection;
  • tonsillitis Plauta - Vincent;
  • CMV infection;
  • acute leukemia;
  • toxoplasmosis;
  • hepatitis B;
  • diphtheria;
  • rubella.

If the patient goes to the clinic complaining of a sore throat, then the doctors usually do not refer the patient to the laboratory.The unreasonable administration of ampicillin and a number of other antibacterial drugs is a typical cause of a profuse rash in patients with myocardial infarction.

Diagnostic measures

In addition to the local pediatrician or therapist, the patient should be examined by an ENT doctor, immunologist. Specialists pay attention to typical symptoms - exudative pharyngitis, lymphadenopathy and fever. Determine the type of infection allows laboratory tests of varying degrees of complexity.

An idea of ​​the strength of inflammation can be obtained by the results of a general blood test (leukocytosis, increased ESR). Serological tests detect antibodies to certain types of herpes viruses. To search for the pathogen DNA in the blood, saliva, oropharyngeal epithelial cells, a polymerase chain reaction is used.

Atypical lymphocytes are found in infectious mononucleosis, HIV, CMV, hepatitis, influenza, rubella. The largest number of these abnormal cells is observed only in MI.

How to treat infectious mononucleosis in adults, children

The fight against any pathogenic microbes worsens the state of immune defense. The body is less resistant to infections. For a patient with MI there are other dangers. Physical effort can lead to rupture of the spleen. It is necessary to avoid weight lifting, participation in sports.

Drug therapy

Treatment of myocardial infarction is mostly symptomatic, supportive. The patient needs antipyretic, anti-inflammatory, analgesic medications. Antiviral drugs help better in the very first days of the disease before infection of a large number of lymphocytes.

Symptomatic treatment of infectious mononucleosis:

  • antiseptic and analgesics for the throat in the form of a spray, solution, lozenges (Miramistin, Tantum Verde, Teraflu LAR, Hexoral Tabs);
  • antipyretic and anti-inflammatory drugs (Ibuprofen, Paracetamol, Nimesil, Nurofen, Kalpol, Efferalgan);
  • antihistamines to reduce itching and swelling (Cetirizine, Zirtek, Zodak, Tavegil, Suprastin).

The effectiveness of the antiviral treatment of MI is not well proven. This group of drugs can affect the bone marrow, kidneys.

For a more effective fight against pathogens, immunomodulators are used. Drops with interferon are instilled into the nose for 2 or 3 days. Viferon is prescribed in the form of rectal suppositories. The immunostimulating drug Neovir is released in injections. The course includes 5-7 injections. The immunomodulating and antiviral agent Cycloferon is released in the form of tablets, solution and liniment.

It is possible to stimulate the production of endogenous interferon by taking tinctures of aralia, ginseng, lemongrass, eleutherococcus, and temptation. Echinacea extract contains Immunal. It is better for children to give medicines in liquid form - drops, syrups, suspensions. They less irritate the stomach, are rapidly absorbed, begin to act in 15-30 minutes.

Corticosteroids are useful in severe MI, with difficulty breathing, significant damage to the lymph nodes, spleen. Hormonal treatment is carried out in a short course. Prescribe prednisolone (4-5 days).

Antibiotics do not act on viruses, but help with complications of the underlying disease - bacterial tonsillitis, otitis media, pneumonia, meningitis. The drugs quickly suppress the microflora sensitive to the antibacterial substance, so the inflammatory process quickly subsides.

Homeopathy

Homeopathy is an alternative area of ​​medicine. Therapeutic substances are used in large breeding. Such drugs do not help everyone, they do not replace antiviral drugs and antibiotics. Homeopaths prescribe treatment individually after examining the patient. The following remedies are prescribed: Fitolyakka, Barita carbonika, Mercury preparations.

Folk remedies

It is recommended to rinse the throat and pharynx with tincture of propolis, calendula diluted with water. You can use a suspension of sea buckthorn oil in chamomile infusion.A simpler option is a solution of soda with sea salt. Gargle from 3 to 5 times a day.

You can take folk antiviral agents - tincture of echinacea, garlic. They offer the patient to drink tea with lemon and honey, infusions of milk thistle, rose hip, chamomile.

Diet for mononucleosis

During a period of fever, appoint table number 13, designed for febrile patients. Give plenty of fluids to drink. The menu includes low-fat broth, boiled or stewed meat, mashed vegetables.

If the liver functions are impaired, then banned are fatty and fried meat, sausage, confectionery. The patient is prescribed table number 5. Prepare vegetable soups, mashed potatoes, viscous cereals, boil chicken, rabbit. Limit animal fats.

Forecast and consequences

In mild cases, outpatient treatment of myocardial infarction is allowed. From 20 to 50% of infected patients recover within 1–2 weeks. After the acute form of the disease, most patients recover completely. The causative agent remains for life in the human body.

The negative consequences of acute myocardial infarction are a transition to a chronic form, periodic exacerbations of the disease, and an increased risk of complications.

Due to severe swelling of the cervical lymph nodes, obstruction of the airways occurs, the patient suffocates. Hepatic complications are manifested by high levels of liver enzymes. Neurological consequences, in addition to meningoencephalitis, include convulsions, paralysis of the cranial nerves.

Other complications of myocardial infarction:

  • renal failure;
  • bacterial tonsillitis;
  • thrombocytopenia;
  • pneumonia;
  • myocarditis;
  • hepatitis;
  • otitis.

Severe MI is a sign of weakened immunity. Complications in 1% of cases are fatal. Modern researchers suggest that types 4, 5, and 6 herpes viruses are involved in the development of allergies, chronic fatigue, autoimmune and oncological diseases.

Prevention

The patient must avoid heavy physical labor, some sports for 1-3 months, in order to prevent rupture of the spleen. Prevention of MI contributes to increased resistance to pathogenic microorganisms. For this, it is necessary to conduct hardening, vitamin therapy, take tinctures of plants with antiviral, immunostimulating effects.

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