Infectious mononucleosis in children: symptoms, treatment and methods of prevention. Mononucleosis in children: symptoms and treatment (Komarovsky). Infectious diseases What is mononucleosis in children and symptoms
Symptoms of mononucleosis
The duration of the incubation period varies, according to different authors, from 5 to 21 days, more often is 7-10 days.
The beginning of the disease is more likely sharp, with lifting body temperature to high digits, but the entire clinical symptom complex is usually developing by the end of the first week. The earliest symptoms are the increase in temperature, the difficulty of nasal respiration, the swelling of the cervical lymph nodes, angina.
By the end of the first week, the larger liver and spleen are already determined from the beginning of the disease, and atypical mononuclears appear in the blood.
With the gradual start of the disease for 2-5 days, general ailments are noted, a slight increase in temperature, there may be moderate catarrhal phenomena on the side of the upper respiratory tract. Part of patients initial temperatures may even be normal and only by the end of the first week it becomes high, in the midst of the disease rising to 39-40 °. Rarely infectious mononucleosis can proceed at normal temperature from the beginning. There is no typical temperature curve. It usually decreases timetable. The decrease in temperature coincides with the improvement general status and the disappearance of other symptoms of the disease.
An important symptom of infectious mononucleosis is an increase in all groups of lymph nodes, mainly cervical. They are visible to the eye, when palpation is dense, elastic, low-escaled, are not laugmented with each other and the surrounding fiber. The skin is not changed over them. Their dimensions vary from the pea to walnut or chicken egg. The impodies of them in infectious mononucleosis does not happen. Often, an increase in lymph nodes is the first symptom of the disease. Parellialism The degree of destruction of the rotogling is not: with a slightly pronounced sore throat there can be a significant increase in cervical lymph nodes and with massive overlauses on the almonds it can be moderate. An increase in other groups of lymph nodes is rarely significant.
The permanent symptom of infectious mononucleosis is the damage to the o'clock. It is always noted an increase and swelling of the skydly almonds, the nasopharynk almond is affected, and therefore the pronounced nose congestion, the difficulty of nasal respiration, the suturing of the voice and the "snoring" breath of the half-open mouth. Despite the pronounced nasal congestion, the discharge from the nose in the acute period of the disease usually does not happen, sometimes they appear after the nasal breathing is restored, since the infectious mononucleosis is affected by the mucous membrane of the bottom nasal shell at the entrance to the nasophaling (rear rhinitis). The rear wall of the pharynx is also edema, hyperemic in a hyperplasm of lymphoid tissue (granular pharyngitis) is covered with thick mucus. Zea's hyperemia is moderate, insignificant sore throat.
Almost 85% of children with infectious mononucleosome in the sky and nasoplary almonds, raids appear in the form of islands and strips, sometimes solid in the first days of the disease, sometimes in 3-4 days. When they appear, the body temperature is even more increased and the general state is significantly deteriorated.
An increase in the size of the liver and spleen in infectious mononucleosis is observed almost constantly (97-98% of cases). The liver begins to increase from the first days of the disease and reaches a maximum of the 4-10th day. Sometimes there is a moderate jaggility of the skin and scool. Jaundice usually arises in the height of infectious mononucleosis and disappears parallel to the disappearance of other manifestations of the disease. The frequency of the appearance of jaundice does not depend on the intensity of the increase in the size of the liver. Hepatitis does not happen. The size of the liver is normalized only at the end of the first - early second month from the moment of the disease, remaining in some cases increased within three months.
One of the early symptoms of infectious mononucleosis is to increase the spleen in the first days of the disease, reaching the maximum sizes on the 4-10th day. At 1/2 patients, by the end of the third week, the spleen is not palpable from the beginning of the disease.
Often there is an endlessness of the face and the edema of the eyelids.
In the midst of the disease, various rashes on the skin are often. The rash can be a corppy, urticar, scarlatin-like, hemorrhagic. On the mucosa of the mouth appear Exanthem and Petechia.
From the side of the cardiovascular system, tachycardia is noted, the muffledness of cardiac tones, sometimes systolic noise, which usually disappear as they recovery. There is no serious changes to the ECG.
In general blood test - moderate leukocytosis, atypical mononucleiclars (they are called even more empty lymphocytes). In most cases, they are found in the first days of the disease, especially in the midst of it, most children are within 2-3 weeks from the beginning of the disease. The number of atypical mononuclears in infectious mononucleoset ranges from 5-10 to 50% and higher. Receives a distinct connection of the number of atypical mononuclears with the severity of the disease.
There are typical and atypical forms of infectious mononucleosis. With atypical (erased and asymptomatic) forms, the leading symptoms characteristic of infectious mononucleosis are poorly pronounced or completely lacking, and the diagnosis is carried out on the basis of hematological and serological data.
These gravity in typical forms are: the severity of general intoxication, the degree of increasing lymph nodes, the nature of changes in the rotoglot, the degree of difficulty of nasal respiration, the severity of the increase in liver and spleen and changes in the general blood test.
The course of infectious mononucleosis in most cases ends after 2-4 weeks, sometimes after 1-1.5 weeks. Normalization of the size of the liver, spleen, lymph nodes can be lined by 1.5-2 months. For a long time, atypical mononuclears in the blood can also be detected.
The recurrences and chronic flow of infectious mononucleosis in children do not happen.
Complications are usually associated with the activation of microbial flora and especially with the layering of ARVI - acute respiratory viral infection (bronchitis, pneumonia, otitis).
The forecast is favorable. The disease in 80% ends with recovery in 2-3 weeks. In some cases, the long-term preservation of changes in the blood is possible - up to 6 months and more.
In the world literature, single cases of deadly outcomes are described on the spray of the spleen or from the damage to the nervous system in the form of bulbar or encephalitic forms.
Differential diagnosis of infectious mononucleosis is carried out with rotogotage diphtheria, sharp respiratory viral diseases, especially adenoviral etiology, acute leukemia, viral hepatitis.
Infectious mononucleosisaccompanied by an angina, differs from the rotogling diphtheria character and color of the raids, the inconsistency of the lesion of the zea increase in the lymph nodes (changes in the zev can be insignificant, and the increase in lymph nodes is sharply pronounced), an increase in liver and spleen, the presence of polyadenitis, typical blood changes (atypical mononuclears).
The general condition of infectious mononucleosis is usually increasingly increasingly, despite the pronounced hamper of the nasal respiration and the high body temperature. In case of infectious mononucleosis, a longer fevering period, in contrast to diphtheria, at which the elevated body temperature is kept no more than 3-4 days, and further decreases, despite the progression of local changes in the rotoglot.
Large difficulties occur with the differential diagnosis of infectious mononucleosis and ARVI, especially adenoviral etiology, at which mononucleosus-like syndrome can be expressed. Differences: pronounced catarrhal phenomena (runny nose, cough, wheezes in the lungs) are not characteristic of infectious mononucleosis; Liver and spleen with ORVI, if they increase, slightly and mainly in adenovirus infection in young children. Atypical mononuclears for ORVI are rarely determined, once in a small amount not exceeding 5-10%. Conjunctivitis in infectious mononucleoset does not happen.
Finally, the issue is solved after serological reactions.
Cases of infectious mononucleosis accompanied by high leukocytosis (30-60 g / l) and lymphocytosis (80-90%), it is necessary to differentiate from acute leukemia for which the sharp pallor of the skin is characterized, a decrease in the number of erythrocytes and hemoglobin, significantly accelerated ESO. The final diagnosis is set according to the result of a sterile puncture.
With a differentiated diagnosis of infectious mononucleosis and lymphoganululetsis, the duration of the course of the disease (months), the wave-like temperature of the temperature curve, the absence of damage to and nasopharynx, the leukocytosis of a neutrophilic nature indicate lymphogranulomatosis. In doubtful cases, it should be resorted to the puncture of the lymph node. The presence of Berezovsky-Sternberg cells in the lymph node confirms the diagnosis of lymphoganululetosis.
Infectious mononucleosis, accompanied by jaundice, should be differentiated from viral hepatitis. Long-grained body temperature and the presence of atypical mononuclears in the blood are not characteristic viral hepatitis. The presence of pronounced biochemical shifts in blood serum (increase in bilirubin, transaminase activity, thymol sample, etc.) and negative serological reactions exclude the diagnosis of infectious mononucleosis.
Infectious mononucleosis in children of the first year of life has some features. At the beginning of the disease in early children, in almost half of cases, a runny nose is celebrated, sometimes cough. Often since the first days of the disease, there is a snoring respiration, the endlessness of the face, the pastosity of the eyelids, cervical fiber, and polyady. Early (in the first three days) angina appears with overlaps on almonds. More often there are rashes on the skin. In the blood of children of early age, often in the first days of the disease there is an increase in rod and segmented neutrophils.
The positive results of serological reactions are less common in lower titers than older children. Particularly difficult to differentiate infectious mononucleosis in children of the first three years of life from ARVI, which are often accompanied by mononucleosic syndrome.
The course of illness in young children is favorable and ends with complete recovery.
What is mononucleosis in adults
Mononucleosis in adults
Mononucleosis is a rather dangerous disease, although it is very rare.
Synonyms for infectious mononucleosis are a ferrous fever, Filatov's disease, a PFFEF disease, monocytic agnus, exists and the other names of this disease.
Causes of mononucleosis
This disease provokes the Epstein Barra virus, and it is manifested in the form of fever, tonsillitis, generalized lymphadenopathy, certain changes in the hemogram, an increase in the spleen and liver, the disease can also receive a chronic form.
Epstein-Barra virus belongs to the four-type herpes group.
The source of infection during mononucleosis is a sick person, however, the disease of Malokontagino, due to a high percentage of immune persons. Although the transfer of infection and is carried out by air-droplet, but it happens more often with saliva (in particular, when kisses). In addition, there is a possibility of transmitting infection with blood flowing.
People older than forty years are very rarely sick with mononucleosis, but HIV-infected reactivation of Epstein-Barra virus can occur at any age.
When infected, part of the affected cells die, and the released virus affects new cells, as a result of which cellular and humoral immunity is disturbed.
Against the background of the flow of lymphadenitis and increasing the liver and spleen, dyspeptic phenomena and abdominal pain are often observed. In each tenth patient, the jaggility (character) of the skin and the scler is noticeable.
Conventional laboratory samples can show some violations in the liver activity. Probably the emergence of a rash, bearing a podhid-papular, urticar, or hemorrhagic character. Pretty characteristic are changes from the blood, which can be determined from the very first days of the disease, but in some cases it is possible to notice much later.
Very often determined leukocytosis and the increase in the number of monocytes and lymphocytes, the ESO increases moderately. In addition to conventional lymphocytes, the atypical single-core larger size is observed - atypical mononuclears.
Infectious mononucleosis is characteristic of the lesions of the lymphoid tissue of the throat and almonds. Over time, the growth of not alone submandibular, but also elbow, axillary, inguinal, especially rear, and in some cases and the tracheo-bronchial lymph nodes are noticeable. There is a well-known triad symptoms in the form of lymphoacident, fever and tonsillitis. Present on the pain in the throat and dysphagia, but nasal breathing is not difficult. It is determined by a nasal tint. The almonds are inflamed and increased. There are symptoms of Qatarral, follicular, film, ulcerative-necrotic angina, in some cases with a passionist. From the mouth is felt by a sweet-shovel smell.
Diagnostics
Mononucleosis can be determined by the analysis of blood from the finger on the mononuclear. In peripheral blood, with this disease, a large number of empty mononuclear materials contain
In a light version of the disease, therapeutic measures can be carried out at home, easy course of the disease and the possibility of the patient's isolation can be carried out at home. However, severe conditions require hospitalization into an infectious office. Be sure to be assigned bed mode, the treatment is made in accordance with the symptoms.
Antibiotics are prescribed only in the presence of bacterial complications, however, ampicillin and oxacillin with this disease are categorically contraindicated. It is very often prescribed a short course of glucocorticoid therapy.
In the treatment of mononucleosis, human immunoglobulin against Epstein-Barra virus is used.
Folk methods provide for the treatment of liver with hofitol or terminated, and immunity should be improved by Echinacea.
Signs and symptoms of chronic mononucleosis in adults
Mononucleosis or ferrous fever, monocytic angina, PFFEF disease, etc. - disease caused by the Epstein-Barr virus. In the clinical characteristic, fever, generalized lymphodenopathy, tonsillitis are distinguished. An increase in liver and spleen, characteristic changes in the blood formula. In some cases, the disease can take chronic form.
The Epstein Barr virus is a human-lymphotropic virus, refers to herpes viruses group. It can be hidden in cells of an infected person in the form of a dormant infection for a long time, so the source of infection is a sick person or a virus carrier. Mostly people suffer up to 40 years old, after the suffered disease, everyone has a resistant immunity to mononucleosis.
The virus is allocated to the environment, starting from the last days of the incubation period. Duration - 6-18 months. Epstein Barr Virus Transmission Mechanism, through a kiss, dirty hands, dishes, hygiene items. When overflowing blood and during childbirth from the infected mother.
Exists high degree susceptibility to infection, but when infected may develop both light and erased clinical forms. The spread of the infection occurs everywhere, there is no epidemic outbreaks, there is an increased incidence of girls in 14-16 years and in young men in 16-18 years. In the case of infection with a virus at high age, the disease does not have pronounced symptoms.
Since most adult people have been for 30-35, specific immunity has already been formed, the clinical course of the disease is rare. When inhaling the air with a virus of a person occurs, the cells of the epithelium of the upper respiratory tract occurs, the pharynx language. Moderate inflammation of the mucous membrane develops, with the Lymph current infection enters nearby lymph nodes, which contributes to the appearance of lymphadenitis.
In blood, the virus captures in lymphocytes, and begins to actively spread. As a result, the reactions of a specific nature are formed, and pathological damage to cells is formed. In the blood vessels, the pathogen is transported by the body, achieving important bodies. Epstein-Barr virus lives in a person's body all his life if immunity decreases, it manifests his negative impact.
Sometimes weakness can occur, malaise, catarrhal symptoms and if not to take measures and not to establish an accurate diagnosis in such cases there is a gradual increase in symptoms. Weakness increases, the temperature increases, the nasal is concluded, the difficulty of breathing, and the sore throat. In the acute period there is an increased sweating, intoxication.
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Patients complain of lubrication in muscles, headache. swallowing pain. Fever torments a patient several days, and even a month, the flow may be different. A week later, the disease should move the aggravation phase. Common inxication, angina manifest. swelling of lymph nodes, increase in liver and spleen.
The patient's condition can deteriorate significantly. It can be found in the throat catarrhal, ulcerative-necrotic processes, a film or follicular angina with intensive redness of the almond mucosa, yellowish and loose raids. During the examination, the graininess of the rear wall of the pharynx and hemorrhage of the mucous membrane is detected.
From the first days of the disease there is a multiple lesion of the glands (polyadenopathy). The increase in lymph nodes is detected easily in virtually any zone available for research using palpation. The defeat is most often tentacious, submandibular nodes. In the process of feeling, the density of lymphatic nodes is determined, they are usually dense, movable, painless or with a weak manifestation of pain.
There is a swelling of the surrounding fiber, the jaggility of the scool and skin, the dark urine is distinguished and dyspepsia appears. Frequently stained, papules and various rashes, the place of their localization is different. The rash passes quickly, does not have itching, burning skin. The sharp period lasts about 2-3 weeks. Then it is time for the gradual sacrament of clinical symptoms and comes the process of restoring the normal life of the body.
The temperature of the body is normalized, signs of angina, the liver and spleen are disappearing their natural dimensions. It happens that many weeks there are signs of adenopathy and subfebristitta. In case of chronic recurrent flow, the period of the disease is extended.
Consequences of mononucleosis in adults
Complications for mononucleosis may be absent or being very heavy, sometimes the disease ends with death. One of the causes of death is a break of a spleen. There are cases of developing severe hepatitis, tachycardia. Psycho, inflammation of the kidneys.
Paraceptions of mimic muscles, cranial nerves occur.
Sometimes you have to pass through the pneumonia, to deal with the eyelid. It is possible to narrow the lumen of the larynx (obstruction of the respiratory tract), requiring urgent surgical intervention. Treatment should be carried out in a timely manner, if at the first signs of illness to seek help to a doctor, the effects of mononucleosis can be avoided.
Mononucliosis in children and adults. Symptoms, treatment, consequences
The virus appears in the patient's saliva during the period of the sickness of the disease, it is rarely maintained to half a year after recovery. With the latent flow of the disease, the causative agent can sow in the epithelium lining oral mucosa, and affect the lymphocytes responsible for humoral immunity.
Mononucleosis in adults: symptoms and signs
Infectious mononucleosis is characterized by the appearance the following symptoms:
Angina;
Fever;
Damage to lymphatic nodes;
Defeat of spleen and liver;
Changes in the picture of the blood.
Signs of mononucleosis. The disease begins with an increase in body temperature. The temperature during mononucleosis can rise to 40 s and decrease to normal indicators by the morning. The temperature is accompanied by weakness, pain in the joints and muscles, the lack of appetite, headaches, dizziness and migraine.
Fever with mononucleoset can last from several days to several months and accompanied by an increase in lymph nodes. Mortally suffer, inguinal, medioched and lymph nodes located at the rear edge of the breast-curable-bed-like muscle.
They are able to increase in size up to 3 cm in diameter, which rushes into the eye when inspection, mobility and soreness are detected during palpation. The affected lymph nodes are not soldered with the surrounding tissues and do not cause changes in covering skin.
Angina, which occurs in infectious mononucleosis, may be several species:
1. Lacooner;
2. Catarial;
3. Follicular;
4. Journal-necrotic.
Practically from the first days of the disease, due to severe intoxication, an increase in spleen and liver (hepatosplegegaly) is revealed, reaching a maximum of 4-10 days of illness. Thanks to the defeat of the liver parenchyma, additional symptoms of mononucleosis can develop:
- the jaggility of the skin;
- Ikler's eye scool;
- increasing the activity of hepatic transaminase in the blood.
Often, mononucleosis symptoms are expressed in the form of the appearance on the skin of a rash (ultra-pouch, pypural or hemorrhagic), which appears after antibiotic therapy. Changes in blood pattern is characterized by the presence of atypical mononuclears and an increase in single-core cells - monocytes and lymphocytes.
Infectious mononucleosis in children
When contacting a child with patients with mononucleosis, it is necessary to carefully monitor its condition within 2-3 months. If no manifestations appear during this time, then we can assume that the child has not infected.
The clinical picture of mononucleosis in children is identical in adults. The disease begins with signs of intoxication, and the temperature in mononucleosis depends on the severity of the course of the disease. Children's mononucleosis can begin with bright and explicit symptoms, and may occur in the form of light ailment and low temperature.
The appearance of rash is not related to the use of antibiotics and also appears at the beginning of the disease. Pull elements do not bope, so no treatment requires. But if the rash is accompanied by itching, then it speaks of allergies to any accepted drug.
The increase in lymph nodes in a child (polyadenitis) is clearly pronounced, and flows in symmetric lymph nodes. Hyperplasia is so significant that when inspection is striking. With an increase in lymph nodes in the abdominal cavity, squeezing of near nerve endings may occur, which will lead to the appearance of symptoms of the "acute abdomen".
The presence of such manifestations is often the cause of incorrect diagnosis. The active growing of lymphoid tissue in the rotoglot can lead to the difficulty of nasal breathing. But the visible rhinitis is not accompanied by the release of the mucus, in contrast to typical inflammatory processes.
Hepatoslenomegaly appears in the first days of the disease and progresses within 2-4 weeks. Even when recovered, the increase in liver and spleen can continue for some time that requires constant observation due to the danger of body breaks.
Treatment and diagnostics
Diagnosis of the disease does not cause difficulties. 4 studies are enough to diagnose with confidence:
1. Blood test - the presence of IgM, IgG;
2. Common blood test - leukegram shift in left, the presence of atypical mononuclear;
3. Blood biochemistry - increased hepatic transaminases;
4. Ultrasound - hepatoslenomegaly.
The therapeutic tactics of the treatment of mononucleosis is determined by the attending physician. Immunoglobulin is mainly used against Epstein-Barra virus and supporting drugs for the liver and spleen. Under layering bacterial infection Add antibacterial therapy. For severe courseTo prevent the development of serious complications, glucocorticoid therapy is carried out.
Consequences and complications
The development of complications of mononucleosis is explained by the accession of other infections or activation of the existing bacterial flora. As a result, the following pathologies and consequences of mononucleosis can develop:
The infection from the ointment can go to nearby fabrics and organs and cause sinusitis, tonsillitis, paratrozillitis, otitis, bronchitis, pneumonia, etc.
Due to the heavy load on the liver, there is a danger of developing liver failure and hemolytic anemia.
In isolated cases, the increased spleen can give a break.
Antibiotics treatment can cause the appearance of a rash that can leave on the skin scars.
Infectious mononucleosis in children - symptoms, treatment, complications
Disease called infectious mononucleosis was first described by N.F. Filatov in 1885 and became referred to as idiopathic lymphadenitis. This is an acute infectious viral disease, which is characterized by an increase in the size of the spleen and the liver, the change in white blood and the disorder of the reticulorendothelial system, complicated by lymphadenopathy.
It has been established that this ailment causes a special Herpety Epstein-Barr (type 4) virus, affecting lymphoid-reticular tissue. Finding into the organism by air-droplet, it strikes the epithelium of the oral chipboard, then with blood flow and regional lymph nodes. The Epstein-Barr virus remains in the human body for life, and when immunifying can periodically recur.
Causes of infectious mononucleosis in children
Most of all children under 10 years old are predisposed to this disease. As a rule, the child is often located in a closed team, for example, in kindergarten or at school, where the transmission of the virus is possible by air-droplet. The virus dies very quickly when entering the environment, so the infection occurs only with close contacts, so it cannot be called very contagious. The Epstein Barr virus in a sick person is in saliva particles, so infectious mononucleosis can be transmitted from a person to person with:
- kiss
- cough
- sneeze
- use of shared dishes
It is noteworthy that the boys are sick of infectious mononucleosis twice as girls than girls. Thus, there is a chance to easily become infected with chichany or cough, especially in the spring and in the autumn-winter period. Some people do not have any symptoms of the disease, but are virus monasters and represent a potential danger to others. The virus penetrates the body through the respiratory tract, and the incubation period of the disease is approximately 5-15 days. In some cases, it can last up to one and a half months.
Epstein-Barr virus is a very common infection, up to 5 years of age, over 50% of children are infected with this type and most of it causes serious symptoms and disease. Moreover, the infection of the adult population according to various data is 85-90% and only in some children or adults this virus is expressed by the symptoms that are called infectious mononucleosis.
Symptoms of mononucleosis in a child
Since today, there are practically no prevention from infection with viruses if the child contacted patients with infectious mononucleosis, parents should closely monitor the health of the child in the next 2-3 months. If the symptoms of the mononucleosis appear, therefore, or the child has become infected, or the immunity coped with the virus and the infection passed safely.
If the child appeared the symptoms of general intoxication - chills, temperature, weakness, rash, the lymph nodes increased - to which doctor to appeal? First, to the district pediatrician or family doctor, then to the infectious background.
Symptoms of infectious mononucleosis are diverse. Sometimes there are common phenomena of a prudent nature, such as malaise, weakness and catarrhal symptoms. Gradually, well-being worsens, the temperature increases to the subfebrile, there is a constant deal in the throat and difficulty in respiration due to the nasal congestion. A characteristic phenomenon can also be called hyperemia of the mucous membrane shell, as well as the pathological growth of almonds.
Sometimes the disease begins suddenly, and its symptoms are pronounced. In such a situation, it is not excluded:
- fever, it proceeds in different ways (usually 38 -39c) and lasts for several days or even a month
- increased sweating, chills, drowsiness, weakness
- signs of intoxication - headache, lubrication in muscles and pain in swallowing
- angry - arises the graininess of the rear wall of the mucous pharynx, its hyperemia, follicular hyperplasia, probably hemorrhage mucous membrane
- hepatoslenomegaly - the increase in the liver and spleen
- lymphadenopathy - an increase in lymph nodes
- general intricensication of the body
- the appearance of rash on the body
The rash with mononucleoset most often occurs at the beginning of the disease, simultaneously with fever and lymphadenopathy, while it can be enough intensive, localized on the legs, hands, face, abdomen and back in the form of small red or pale pink specks. The rash does not require treatment, since it does not bope, it can not be smeared with anything, it is independently eliminated as the struggle of immunity with a virus. However, if the child was prescribed an antibiotic and the rash began to scratch - this indicates an allergic reaction to the antibiotic (most often it is a penicillin series of antibiotics - ampicillin, amoxicillin), because the rash during mononucleosis does not bope.
However, the most important symptom of infectious mononucleosis traditionally consider polyadenitis. It occurs as a result of hyperplasia of lymphoid fabric. In most cases, the almonds of the nasopharynx and the sky are developing island overlays of a gray or white-yellowish shade. Their consistency are loose and buggy, they are easily removed.
In addition, peripheral lymph nodes increase. They are delayed by an active breeding virus. The lymph nodes on the back surface of the neck are particularly intense: they become very noticeable when the child turns his head to the sides. Nearby arranged lymph nodes are interconnected, and almost always their defeat is bilateral.
Palpation of lymph nodes is not very painful, they are movable and not tightly in contact with the skin. Sometimes the lymph nodes in the abdominal cavity increase - they squeeze the nerve endings in this area and provoke the occurrence of signs of acute abdomen. This can lead to the formulation of inaccurate diagnosis and conducting a surgical operation.
For infectious mononucleosis, hepatosplegegaly is characterized, that is, a pathological increase in spleen and liver. These organs are very sensitive to the disease, so the changes in them begin to occur already in the first days after infection. The spleen may increase so much that its fabrics can not withstand pressure, and it breaks.
The first 2-4 weeks there is a continuous increase in the size of these organs, to some extent it continues after the recovery of the child. When the body temperature returns to physiological values, the state of the spleen and the liver is normalized.
Diagnosis of the disease
To begin with, to confirm the diagnosis of infectious mononucleosis in a child, the doctor usually prescribes the following tests:
- Blood test for IGM antibodies, IgG to Epstein-Barr virus
- General I. biochemical analysis blood
- Ultrasound of internal organs, primarily liver and spleen
The diagnosis of children's infectious mononucleosis is quite compatible. The main signs of the development of the disease are tonsillitis, increased lymph nodes, liver and spleen, fever. The doctor cannot determine the angina in a child or infectious mononucleosis, so serological studies are required. Hematological changes serve as a secondary symptom of infectious mononucleosis.
Blood test during mononucleosis in children:
- According to the results of the overall blood test, it is possible to judge the number of leukocytes, lymphocytes and monocytes.
- Soe also raised.
- Of course, the indicator of the presence of atypical mononuclears - cells with large basophilic cytoplasma is important. On the development of infectious mononucleosis, there is an increase in their blood content to 10%. It should be borne in mind that atypical elements appear in the blood not immediately, but sometimes only after 2-3 weeks after infection. Atypical mononuclears are oval or round elements whose size can reach the size of a large monocyte. These atypical elements are also called "monolimphocytes" or "empty lymphocytes".
In differentiation of the diagnosis, first of all, it is necessary to distinguish tonsillitis from angina, eliminate the disease of Botkin, acute leukemia, lymphogranulomatosis and the diphtheria, which have similar symptoms. For the most accurate diagnosis in complex cases, the antibody titer determination is carried out to a specific Epstein-Barra virus. There are also fast modern methods of laboratory studies that allow you to get the result after a short time, such as PCR.
Persons patients with infectious mononucleosis are subjected to several serological studies conducted once a few months, for determining the presence of HIV infection, since it also provokes increased content In the blood of mononuclearov.
Also, when the symptoms of Angina need to visit the otolaryngologist and to hold a pharyngoscopy to correctly determine the cause of this disease, as it can be of different etiology.
How not to infect the sick child to adults and other children?
If in the family there is a child or an adult, which fell ill with infectious mononucleosis, not to infect the rest of the family members will be quite difficult, not because the virus is very infectious, but because even after recovery, a child or adult can periodically distinguish a virus with saliva particles Environment and remains a virus monitor for life.
Therefore, there is no need for quarantine with infectious mononucleoset, even if healthy family members during the child's disease are not infected, for sure, the contamination will occur later, during the period when the patient is already corrected and returns to the usual routine of life. With a light course of the disease, you should not isolate a child and install quarantine, he can return to school as soon as recover.
How to treat infectious mononucleosis in children
To date, there is no specific treatment for infectious mononucleosis in children, there is no uniform therapy scheme, there is no antiviral drug, which would effectively suppress the activity of the virus. Typically, the disease is treated at home, in severe cases in hospital conditions and is recommended exceptionally bedding.
Clinical readings for hospitalization:
- High temperature 39, 5 and above
- pronounced symptoms intoxication
- the development of complications
- the threat of asphyxia
There are several directions for the treatment of mononucleosis in children:
- Therapy is mainly aimed at the removal of symptoms of infectious mononucleosis
- Pathogenetic therapy in the form of antipyretic agents for children (ibuprofen, paracetamol in syrup)
- Antiseptic local drugs to relieve angina, as well as local nonspecific immunotherapy, prescribe drugs of IMUDON and IRS 19.
- Desensitizing means
- Locular therapy - vitaminotherapy, including vitamins of group B, C and R.
- When detecting changes in the liver function - a special diet is prescribed, choleretic drugs, hepatoprotectors
- Immunomodulators in conjunction with antiviral drugs have the greatest effect. Imudon can be appointed, Children's Anaferon, Viferon, as well as cycloferon in a dose of 6-10 mg / kg. Sometimes there is a positive metronidazole effect (trichopol, flagil).
- Since the secondary microbial flora is rarely attached, antibiotics are shown, which are prescribed only in the case of complications and intensive inflammatory process In the rotoglotka (except for antibiotics of a penicillin row, which precisely with infectious mononucleosis in 70% of cases cause severe allergic reactions)
- In antibiotic therapy simultaneously prescribe probiotics (acipol, napin, primoofilus children, etc., see the entire list of probiotics preparations with prices and composition)
- With severe hypertoxic flow, a short term prednisolone is shown (20-60 mg per day for 5-7 days), it is used at the risk of asphyxia
- Installation of tracheostas and the translation of artificial ventilation of the lungs are carried out with a strong swelling of the larynx and with difficulties with breathing in children
- When the spleen breaks, splenectomy is carried out in an emergency order.
Forecast and consequences of mononucleosis
Infectious mononucleosis in children, as a rule, has a fairly favorable forecast. However, the main condition for the absence of consequences and complications is timely diagnosis leukemia and regular monitoring of the change in blood composition. In addition, it is very important to follow the condition of children before their final recovery.
In one clinical study, which was conducted in order to find out the duration of the process of restoring children and adults who have undergone mononucleosis, 150 people participated. For half a year, patients after the transfer of the virus were observed by doctors, for their health. The results of the study are as follows:
- Normally, if the body temperature in infectious mononucleosis above 37.5 is preserved the first few weeks from the beginning of the disease. Also, the temperature is less than 37.5, that is, the subfebrile can be considered normal.
- Angina with infectious mononucleosis or throat pain lasts on average 1-2 weeks
- Lymph nodes are returned to a normal state during the first month of the disease.
- Sleepiness, increased fatigue, weakness to persist after illness long enough - from several months to six months.
Therefore, those who have surtered children need a dispensary examination over the next 6-12 months to control the residual phenomena in the blood.
Complications of infectious mononucleosis occur quite rarely, but the most common among them is the inflammation of the liver, causing jaundice and characterized by the darkening of urine and the yellowing of the skin.
One of the most serious consequences of mononucleosis in children is to break the spleen, but it is found in 1 case out of a thousand. This happens when thrombocytopenia develops and an extracting of a lienal capsule, which entail a spleen break. This is an extremely dangerous state at which the child may die from internal bleeding.
Other complications, consequences are mainly related to the development against the background of mononucleosis of a secondary infection, mainly streptococcal and staphylococcal. Meningoencephalitis may also appear, which manifests itself in obstruction of the respiratory tract and increase the almonds, severe hepatitis forms and bilateral interstitial infiltration of the lungs.
There are a number of scientific research, which established the connection of the Epstein-Barr virus, with the development of certain types of cancer, which are rare enough - this different kinds lymphoma. However, it does not mean that if the child has suffered infectious mononucleosis, as a consequence he can develop cancer. Lymphoma is a rare disease and for the development of oncology, the usually provoking factor is a sharp decline in immunity for various reasons.
It is worth noting that events on the specific and effective prevention of infectious mononucleosis currently do not currently exist.
Mononucleosis
Causes, symptoms and diagnostics of mononucleosis, consequences
Definition of mononucleosis
Infectious mononucleosis (mononic angina or ferrous fever) - a disease caused by the Epstein-Barra filter virus (human b-lymphotropic virus) relating to the Herpes viruses group. It can be present for a long time in human cells in the form of a hidden infection.
Most often, children are subject to the disease, outbreaks of disease are celebrated all year round, but the most high level The incidence is achieved in the autumn months. Mononucleosis is sick once, after which a lifelong resistant immunity is produced.
Causes of mononucleosis
The disease is transmitted from a sick person in a sharp period, and with erased diseases of the disease, the source is also a virus carrier. Usually, infection occurs during close contacts, when the virus is distributed by air-droplet, with kisses, transmission is possible during blood transfusions, during a trip to public transport, when using foreign hygiene.
Mononucleosis is striking children with a weak immunity, after transferred stress, with severe mental and physical exertion. After primary infection, the virus is highlighted in the external space for 18 months. The duration of the incubation period ranges from 5 to 20 days. Half of the adult population transfer infection in adolescence.
In girls, infectious mononucleosis happens at the age of 14-16, and the boys are exposed to diseases in 16-18 years. Rarely the disease amazes people over 40 years old, since in the blood of adults there are antibodies to the virus. What is the cause of the rapid development of infection in an infected organism? During the period of the acute phase of the disease, part of the affected cells die, released, the virus infects new, healthy cells.
With violation of cellular and humoral immunity, superinfection develops and the healing of secondary infection occurs. It is notified that the Epstein-Barra virus is able to affect lymphoid and reticular tissue, as a result there is an emergence of generalized lymphoaciadenopathy, an increase in liver and spleen.
Symptoms of mononucleosis
Mononucleosis is characterized by a fever, the damage to the oz (tonsillitis) and lymph nodes, an increase in almonds, strong pain in the throat, an increase in liver and spleen, changes in blood composition, sometimes can take a chronic course. From the first days there are easy malaise, weakness, head and muscular pain, painful sensations in the joints, a slight increase in temperature and weakly pronounced changes in lymph nodes and a sip.
Later there appears soreness when swallowing. The body temperature rises to 38-40 ° C, may have a wave character, such temperature differences are saved during the day and can last 1-3 weeks. Tonnsillitis manifests itself immediately or in a few days, it can be catarle with light swelling of almonds, lacunar with a heavier manifestation of inflammation in both almonds or ulcerative-necrotic with fibrinous film as during diphtheria.
A sharp difficulty of breathing and abundant mucous membranes discontinued, easy nasal congestion, allocating and mucous membranes on the rear wall of the pharynx means the development of naphorgitis. In patients from the nasopharynk, there may be a spell-shaped flare, there are massive loose, cotton-like white-yellow color impositions on almonds.
The disease is accompanied by the damage to the angular jaw and rear cervical lymph nodes, they are most clearly swelling in the cervical group, along the rear edge of the breast-curable-bed-like muscle as a chain or package. The diameter of the nodes can be up to 2-3 cm. Less often increase the axillary, inguinal, cubic lymph nodes.
The infection hurts the lymphotok of the intestinal mesentery, causes inflammation, provokes pathological rashes on the skin in the form of spots, papul, pigment spots. The deadlines for the appearance of rash - from 3 to 5 days after three days, it disappears without a trace. Reversal repeat usually does not happen.
There is no single systematization of clinical forms of infectious mononucleosis, there may be not only typical (with symptoms), but also atypical (without symptoms) of the disease. In histological examination, the involvement in the process of several important bodies is confirmed. The inflammation of the intermediate tissue of the lung (interstitial pneumonia) is developing, a decrease in the number of cellular elements of the bone marrow (hypoplasia), the inflammation of the vascular shell of the eye (takes).
Clinical manifestations of the disease - bad sleep, nausea, abdominal pain, diarrhea, sometimes vomiting. Mononucleosis is characterized by the appearance of intraperitoneal tumors, also bind it to the occurrence of lymphatic lymphoma in patients with reduced immunity.
Diagnosis of mononucleosis
Infectious mononucleosis is quite widespread, its light shape is difficult to diagnose. The peculiarity of this virus is that it prefers to strike a lymphoid fabric, which is in almonds, lymph nodes, spleen and liver, so these bodies suffer most.
In the primary inspection, the doctor on complaints establishes the main symptoms of the disease. In suspected mononucleosis, the blood tests (monopte-test) is appointed, which eliminates other diseases that can cause similar symptoms. The accuracy of the diagnosis is possible only when collecting clinical and laboratory data.
In the blood formula, there is usually an increase in lymphocytes and the presence of atypical mononuclears in the blood. Serological studies make it possible to identify heterophilic antibodies to erythrocytes of different animals.
In saliva, the virus is detected:
- after the incubation period of infection;
- during its development;
- 6 months after recovery;
Epstein-Barr viruses in a hidden form are preserved in b-lymphocytes and in the mucous membrane of the shell of the oral chip. The selection of the virus is observed in 10-20% of patients who, in the past, transferred infectious mononucleosis. In modern laboratories, the laboratory diagnosis of the disease is performed on modern equipment using disposable sterile tools when the biomaterial fence.
A positive result clarifies the presence of infection in the body, the transition of the disease in chronic form, as well as the period intensification of the infectious process. Negative results mean the lack of infection, at the early stage of the course of the disease. To track the development of infection, blood test must be taken every three days.
The consequences of mononucleosis
Complications in infectious mononucleosis are very rare, but if you occur, it can be very dangerous. The hematological complications include increased destruction of red blood cells (autoimmune hemolytic anemia), a reduced platelet content in peripheral blood (thrombocytopenia) and a reduced content of granulocytes (granulocytopenia).
In patients with mononucleosis, the separation of the spleen may happen, the obstruction of the respiratory tract, which sometimes leads to a fatal outcome. There is a danger from diverse neurological complications - from encephalitis, paralysis of cranial nerves, lesions of the facial nerve and as a result of paralysis of the mimic muscles. Meningoencephalitis, Guienen-Barre syndrome, multiple nerve lesions (polyneurite), transverse myelitis, psychosis, cardiological complications, interstitial pneumonia - are also counted for complications in mononucleosis.
After the disease, children are usually even about half a year, fatigue often appears, they should sleep more, including in daytime hours. Such schoolchildren should load less classes at school.
Treatment of mononucleosis and mononucleosis prevention
In the treatment of mononucleosis, symptomatic therapy is used. During the fever period, products with antipyretic effects and abundant drinking are used. With the help of vasoconstrictor drugs, such as ephedrine, Galazoline, etc. Remove the difficulty of nasal respiration.
Apply desensitizing drugs, preventing or weakening allergic reactions, interferon, various immunostimulants or other effective antiviral drugs that are in the arsenal of doctors. Patients prescribe a rinse of the throat with warm solutions of furaciline, soda solution and salty water.
To remove headaches and reduce the temperature, ibuprofen, acetaminophen is recommended. To eliminate pain, reducing the adhesion of the almonds, throat and spleen, it is desirable to take corticosteroids, be sure to undergo the supervision of the attending physician. Special preventive measures in mononucleosis are the same as during ARVI. An important role is played by improving immunity and mobilization of the internal forces of the human body.
It is considered that for treatment easy and the average severity of the disease forms of the patient's stay at rest, i.e. bedding, moderate nutrition. You need to pick up diet products in order not to overload the injured liver. Food 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, low-fat fish and meat, fruit, sweet berries, vegetables and soups of them. You can use cereal, coarse bread. The baby is prohibited by butter, fried, smoked, pickled products, canned food, pickles, sharp seasonings. For benefits will go walks in the fresh air, a calm joyful situation in the house, a good mood.
The regular consultations of the hepatologist's doctor will not interfere with the child, be sure to exemplate from preventive vaccinations. Contraindicated overcooling and overheating, exercise, sports, is useful to engage in therapeutic physical education.
Expert editor: Mochalov Pavel Aleksandrovich | d. n. Therapist
Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medical Case" in 1991, in 1993 "Professional Diseases", in 1996 "Therapy".
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Infectious mononucleosis
Infectious mononucleosis is an acute viral disease, characterized by increasing body temperature, sore throat and an increase in lymph nodes. Also characterized certain changes in blood tests.
What it is?
The disease is caused by the herpes virus of a human IV type, it is also called the Epstein-Barr virus - according to the names of scientists who opened it. Infectious mononucleosis is also called the "kissing disease", as the transfer of the virus in young people can occur with saliva during a kiss.
The infection of the Epstein-Barr virus is quite high, and in all age categories, but the virus itself is not very contagious, a long-term contact with the carrier is required. In early age children, the disease is usually easily and unnoticed, the clinical picture of infectious mononucleosis is developing in adolescent and young age. Adults of the same people in the overwhelming majority are already infected with these virus.
What's happening?
After the primary invasion of the cells lining the nasal cavity, the virus penetrates into the nasopharynx mucous membrane, and then spreads to B-lymphocytes. In these cells, it actively multiplies, which causes the appearance of characteristic symptoms.
The incubation period is on average range from 30 to 50 days (fluctuations from 4 days to 2 months). Major symptoms four:
- fatigue
- increase body temperature,
- sore throat
- an increase in regional (usually cervical) lymph nodes.
Usually the disease begins with a sense of general ailment, which can last until the week, then the body temperature increases - up to 38-39 ° C. There is an increase in lymph nodes to 2-3 centimeters. The process is always involved in the liver, which can manifest itself with a sense of gravity in the right hypochondrium, as well as darkening of urine. In addition, the spleen is affected, which increases in size.
If the sick received an ampicillin antibiotic, the skin rash is almost always observed. From other complications, encephalitis, convulsions, various damage to the nervous system, meningitis and behavior disorders are described. Possible, but, fortunately, a rare complication is the break of the spleen. This condition requires emergency surgical intervention!
The disease lasts one or two weeks, then the gradual recovery begins. Increased lymph nods I. total weakness Can be maintained for three weeks.
Diagnosis and treatment
The doctor puts the diagnosis with the characteristics of the clinical picture, but it is not strictly specific. For example, similar symptoms are observed in cytomegalovirus infection. Infectious mononucleosis can imitate side effects from the reception of some drugs, as well as some infectious diseases.
The diagnosis is established on the basis of the determination of antibodies to the Epstein-Barr virus. In addition, instead of affected in-lymphocytes, the body produces new, having a very characteristic view (mononuclear). Their detection of blood smear microscopy also speaks in favor of infectious mononucleosis. In addition, to eliminate streptococcal angina and other bacterial infections, sowing discharged by almonds.
Most patients with infectious mononucleosis recovers completely. In rare cases (less than 1%), death is possible due to the development of severe complications. Recompusing it is recommended to complete peace until the temperature is normalized and the disappearance of the sore throat. To eliminate the spray of the spleen for 6-8 days, it is prohibited to lift gravity and play sports even when it was not determined by a noticeable increase in the spleen.
To reduce body temperature in infectious mononucleosis, paracetamol is used. Aspirin is not recommended to be applied due to the possibility of the development of the Syndrome Reia.
The suffering disease leaves after an imminent immunity.
Infectious mononucleosis - symptoms (photos) in children and adults, treatment
In infectious diseases, which have more than two hundred, there are a variety of names. Some of them are known for many centuries, some appeared in the epoch of the new time after the development of medicine, and reflect some features of clinical manifestations.
For example, Scarlatina is so called the pink color of the skin rash, and the typhoid is so named, since the state of consciousness in the patient is broken by the type of toxic "prostration", and resembles fog, or smoke (translated from Greek).
But mononucleosis is "mansion": Perhaps this is the only case when a laboratory syndrome is reflected in the name of the disease, which is not visible by a simple eye. What is this disease? How does it affect blood cells, proceeds and is treated?
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Infectious mononucleosis - what is it?
the beginning of the disease can be similar to a cold
First of all, this disease has several other names. If you hear such terms as the "ferrous fever", "Filatov Disease", or "Monocytic Angry", then know this is a mononucleosis.
If you decipher the name "Mononucleosis", then this term means an increase in the content of mononuclear, or single-core cells in the blood. Such cells include special types of leukocytes, or white blood cells that perform a protective function. These are monocytes and lymphocytes. Their content in the blood is not simply increased during mononucleoset: they become modified, or atypical - it is easy to detect when studying a colored blood smear under a microscope.
Infectious mononucleosis is a viral disease. Since it causes a virus, not bacteria, then you immediately need to say that the use of any antibiotics is completely meaningless. But this is often done, since the disease is often confused with an angina.
After all, the mechanism of transmission from mononucleosis is an aerosol, that is, the air - drip, and the disease itself proceeds with the lesion of lymphoid tissue: pharyngitis and tonsillitis (agnus) appears, and hepatosplegegaly appears, or an increase in liver and spleen, and the content of lymphocytes and monocytes increases in the blood, which become atypical.
Who is guilty?
Causes infectious mononucleosis Virus Epstein - Barr, which belongs to herpes viruses. In total, there are almost a dozen families of herpes viruses and even more of their species, but only to this type of virus are so sensitive lymphocytes, because on their membrane they have receptors to the protein of the shell of this virus.
The virus is unstable in the external environment, and quickly dies with any available disinfection methods, including ultraviolet irradiation.
A characteristic feature of this virus is a special effect on the cells. If ordinary viruses of the same herpes and windmills show a pronounced cytopathic effect (that is, leading to cell death), then the VEB (Epstein - Barr virus) does not kill cells, but causes their proliferation, that is, active growth. It is this fact that lies in the development of a clinical picture of mononucleosis.
Epidemiology and the path of infection
Since only people suffer from infectious mononucleosis, the infectious person can infect a healthy person, and not only a bright, but also the structural form of the disease, as well as asymptomatic carrier of the virus. It is through healthy carriers that "cycle of the virus" in nature is supported.
In most cases, the disease is transmitted by air - drip: when talking, screaming, crying, sneezing and cough. But there are other ways for which infected saliva and biological fluids can get into the body:
- kisses, gender;
- through toys, especially those who visited the mouth of the child - a virus carrier;
- through the transfusion of donor blood, if donors are carriers of the virus.
Susceptibility to infectious mononucleosis universal. This may seem incredible, but most of the healthy people are infected with this virus, and are carriers. In underdeveloped countries, where a large crowdness of the population, it occurs in kids, and in developed countries - in adolescent and youthful age.
Upon reaching 30 - 40 years of age, most people are infected. It is known that men suffer from infectious mononucleosis, and people over 40 are very rarely sick: infectious mononucleosis is a disease of young age. True, there is one exception: if the patient is sick with HIV infection, then at any age can not only arise mononucleosis, but also repeat. How does this disease develop?
Pathogenesis
Infectious mononucleosis in adults and children begins with the fact that infected saliva falls into the rotoglot, and there the virus is replicated, that is, its primary reproduction occurs. It is the lymphocytes that are an object of an attack of the virus, and quickly "infected". After that, they begin to transform into plasma cells, and synthesize various and unnecessary antibodies, for example, hemagglutinins that can glue alien blood cells.
A complex cascade of activation and suppression of various immunity links is launched, and this leads to the fact that young and immature in lymphocytes are accumulated in the blood, which are called "atypical mononuclears". Despite the fact that it is their own cells, even immature, the body begins to destroy them because they contain viruses.
As a result, the body weakens, trying to destroy a large amount of its own cells, and it contributes to the addition of microbial and bacterial infection, since the body and its immunity are "occupied by another business."
All this is manifested by a generalized process in lymphoid tissue. The proliferation of immunity cells causes hypertrophy of all regional lymph nodes, the spleen and the liver increases, and in the case of severe the disease, necrosis is possible in lymphoid tissue, and the appearance of various infiltrates in organs and tissues.
Symptoms of infectious mononucleosis in children and adults
High temperature up to 40 - symptom of mononucleosis (photo 2)
Infectious mononucleosis has a "blurry" incubation period, which can continue from 5 to 60 days, depending on the age, state of immunity and the number of viruses in the body. The clinical picture of the symptoms in children and adults is about the same, only kids early manifests the increase in the liver and spleen, which in adults, especially with erased forms, may not be determined at all.
As with most diseases, the infectious mononucleosis has a period of start, gap and recovery, or reconvalues.
Initial period
For the disease, a sharp start is typical. In almost one day the temperature rises, chills occurs, then the sore throat and regional lymph nodes increase. If the beginning of a subacute, then lymphadenopathy occurs at first, and only then the fever and catarrhal syndrome are joined.
Usually, the initial period lasts no more than a week, and people often think that this is the "flu", or a different "cold", but then comes the midst of the disease.
Cleaning clinic disease
Symptoms of infectious mononucleosis photo 3
Classical signs of "APOPheGE mononucleosis" are:
- High fever up to 40 degrees, and even higher, which can stay at such a level, and at less high numbers - up to a month.
- A peculiar "mononucleosic" intoxication, which is not similar to the usual, viral intoxication. Patients are tired, with difficulty stand and sit, but usually retain a moving lifestyle. They have no desire, as with conventional infections, go to bed even at high temperatures.
- Polyenopathy syndrome.
Lymph nodes close to the "entrance gate" are increasing. More often than others are affected by the nodes of the side surface of the neck, which remain movable, painful, but increased, sometimes before the size of the chicken egg. In some cases, the neck becomes bullish, and mobility is limited when the head is rotated. The defeat of the inguinal, axillary nodes is slightly expressed.
This symptom of infectious mononucleosis is preserved for a long time, and disappears slowly: sometimes 3-5 months after recovery.
- Increase and strong edema of sky almonds, with the appearance of loose raids, or angina. They even get closed, which makes breathing difficult. The patient has a mouth, a beech of the rear wall of the pharynx (pharyngitis) occurs.
- Almost always increases the spleen and liver. This symptom of infectious mononucleosis in children is noticed quite often, and is well expressed. Sometimes there are pains in side and right hypochondrium, light yellowness and enhancement of enzyme activity: Alt, Ast. It is nothing but a benign hepatitis, which soon passes.
- Picture of peripheral blood. Of course, this patient does not complain, but the exceptional peculiarity of the results of the tests requires to indicate this feature, as the main symptom: on the background of moderate, or high leukocytosis (15-30), the number of lymphocytes and monocytes increases to 90%, of which almost half are atypical Mononucleara. This feature gradually disappears, and in a month the blood "calms down".
- Approximately 25% of patients marked various rashes: tubercles, points, stains, minor hemorrhages. The rash does not bother, it appears by the end of the initial appearance period, and after 3-6 days disappears without a trace.
rash with infectious mononucleosis photo 4
On the diagnosis of mononucleosis
Infectious mononucleosis is a disease with a characteristic clinical picture, and there is always the ability to identify atypical mononuclears in peripheral blood. This is a pathognomonic symptom, just like fever, an increase in lymph nodes, hepatosplegegaly and tonsillitis, combined.
Additional research methods are:
- Hoff - Bauer reaction (positive in 90% of patients). Based on the detection of hemagglutinating antibodies, with the increase in their titer in 4 or more times;
- Methods of ELISA. Allow to determine markers antibodies that confirm the presence of virus antigens (to capsid and nuclear antigens);
- PCR to detect the virus in the blood and saliva. It is often used in newborns, since they are difficult to focus on the immune response, since immunity is still inconsigned.
Treatment of infectious mononucleosis, drugs
Uncomplicated and light forms of infectious mononucleosis are treated at home and children and adults. Patients with a jaundice, significant increase in liver and spleen, unclear diagnosis. The principles of treatment of infectious mononucleosis are:
- "Liver" table number 5. Diet requires abandoning sharp, smoked, fatty and fried dishes to facilitate the work of the liver;
- The semi-respective mode is shown, abundant, vitamin drink;
- It is necessary to rinse the rotohlit with solutions of antiseptics ("Miramistin", "chlorhexidine", "chlorophyllip"), in order to avoid the addition of secondary infection;
- The antipyretic means are shown from the NSAID group.
Attention! What to treat infectious mononucleosis in children, and what drugs can not be used? All parents must remember that the reception of aspirin in any kind and doses is categorically prohibited in children until they reach the age of at least 12 to 13 years, because they can develop a severe complication - Reia syndrome. Applies only paracetamol and ibuprofen as antipyretic drugs.
- Antiviral therapy: Interferons and their inductors. "Neovir", cycloferon, acyclovir. They are used, although their effectiveness is proved when studying only in the laboratory;
- Antibiotics are prescribed at the appearance of suppuration on almonds, other purulent - necrotic complications. More often than others use fluoroquinolones, but ampicillin can contribute to the appearance of rashes in most patients;
- In the case of suspicion of the separation of the spleen, the patient must be urgently operated on, according to life indications. And always the attending physician should pay the attention of patients who are treated at home that when the jaundice is increasing, the appearance of acute pain in the left side, harsh weakness, reducing pressure, should urgently cause an ambulance and hospitalize the patient to the surgical hospital.
How long to treat infectious mononucleosis? It is known that in 80% of cases, significant improvement occurs between 2 and 3 days of the disease, therefore, active treatment must be carried out at least 14 days from the first sign of the disease.
But, even after improving the state of health, you need to limit the motor regime and sports for 1 to 2 months after discharge. This is necessary, since the spleen is enlarged for a long time, and there is a significant risk of its rupture.
In the event that pronounced jaundice was diagnosed, then the diet must be observed within 6 months after recovery.
The consequences of mononucleosis
After infectious mononucleosis remains persistent immunity. The repeated cases of the disease is not observed. In the form of the rarest exceptions, the mononucleosis may also be a fatal outcome, but it can be caused by complications that have a slight attitude towards the development of the virus in the body: this may be obstruction and respiratory tract, bleeding due to the breaking of the liver or spleen, or the development of encephalitis.
In conclusion, it should be said that WEB is not at all as simple as it seems: remaining to persist in the body for life in the body, he often tries to "show his abilities" on cell proliferation in other ways. It causes Bairkit lymphoma, he is considered a possible cause of some carcinoma, since its oncogenesis is proven, or the ability to "decline" the body to the occurrence of cancer.
It is also not excluded by its role in the rapid current of HIV infection. Of particular alertness is the fact that the hereditary material of the VEB is firmly integrated into the affected cells with the human genome.
It is currently being studied by this phenomenon, and it is not excluded that it is the Epstein Virus - Barr will give a randering to the creation of a vaccine from cancer and other malignant neoplasms.
Infectious mononucleosis - treatment, symptoms, causes, diagnosis and recovery
Infectious mononucleosis is called epstein-Barra virus (DNA-containing Lymphocryptovirus genus virus). The virus applies to the family of herpesviruses, but unlike them causes the death of the host cell (the virus is preferably multiplied in B-lymphocytes), and stimulates its growth.
The reservoir and source of infection becomes sick man or carrier infection. Heals mononucleosis doctor infectiousist. Epstein-Barra viruses in latent form are preserved in B-lymphocytes and in the epithelium of the mucous membrane of the rodogot.
What is mononucleosis
Infectious mononucleosis occurs everywhere, the faces of all age groups are sick. In developed countries, the disease is registered mainly among adolescents and young people, peak morbidity It falls for 14-16 years in girls and for 16-18 years in the young men. In developing countries, children of younger age groups are more often ill.
Rarely infectious mononucleosis occurs in adults older than 40 years, because Most people at this age are immune to this infection. In children under 2 years old, the disease is usually not diagnosed due to latent flow. Infectious mononucleosis little Contagiizen: Mainly sporadic cases, occasionally small epidemic outbreaks.
Symptoms of mononucleosis
The cervical, armpits and inguinal lymph nodes gradually increase, swelling becomes visible. Inflammation of cervical lymph nodes (cervical lymphadenitis), as well as angina relate to typical signs of infectious mononucleosis.
Increased lymph nodes are elastic and painful in palpation. Sometimes body temperature reaches 39.4-40 °. The temperature is kept at a constant level or waxually changed during the day, decreased by times (in the morn) to normal. With increasing temperature, headaches are marked, sometimes strong.
From the first days of illness increases size Liver and spleen, reaching a maximum of 4-10 days. Sometimes dyspeptic phenomena, abdominal pain. In 5-10% of patients there are lightweight leather and scler.
Other symptoms appear:
- jaundice;
- skin rash;
- stomach ache;
- pneumonia;
- myocarditis;
- neurological disorders.
In some cases, an increase in the activity of transaminase in the blood is detected, which indicates a violation of the liver function. In the midst of the disease or at the beginning of the reconnaissance period in patients receiving antibiotics, an allergic rash appears (spotty-papular, urctural or hemorrhagic). It happens more often when appointing preparations of penicillin rowAs a rule, ampicillin and oxacillin (antibodies to them are found in the blood of patients).
The disease continues 2-4 weekssometimes longer. Initially, fever and raids on almonds gradually disappear, and later the hemogram, the size of lymph nodes, spleen and liver are normalized.
In individual patients a few days after the decrease in body temperature, it raisses again. Hemogram changes are saved by weeks and even months.
Symptoms of mononucleosis in children
Children complain about the following symptoms:
- lack of appetite;
- nausea;
- headaches;
- chills;
- pain in the sacral region, in the joints.
Then appears laryngitis, dry cough, throat pain, the temperature rises. In this early period, the disease is diagnosed as influenza. Some children have listed symptoms in a few days disappear. Careful clinical observation states the increase and soreness of cervical lymph nodes. In other children, after this period, a classic picture of the disease is developing.
The latter in some children proceed without features (nose or throat), others - tonsillitiswhich sometimes takes a peptic and even diphtheria. Changes in the throat and almonds become a gate for a secondary infection, sometimes flowing septic.
Typical symptom mononucleosis - rash on nebe. In addition, in addition to the symptoms of Angina, some children appear swelling of soft nose, tongue and larynx, as well as swelling of the oral mucosa. The gums softened, bleeding, are ulcerated.
Sometimes inflammation of the horn shell of the eyes and the mucous membrane appears. Temperature keeps 10-17 daysIn some cases up to the month. Sometimes a subfebrile temperature is kept for months.
The characteristic feature of this syndrome is an increase in the lymph nodes of predominantly cervical and nodes located behind the breast-curable-novel and submadibular muscles (75% of cases), less frequently inguinal and armpits (30% of cases) sometimes occipital and elbow. Especially mesenteric nodes and mediastinal nodes can also increase.
Nodes are increased by or single or groups. As a rule, nodes are small, elastic, painful when pressing, which often happens in cervical nodes And then only if there are big changes in almonds. It rarely occurs a symmetric increase in nodes. Pain in the stomach, nausea, vomiting and diarrhea are associated with increasing mesenteric nodes.
Descriptions of symptoms of mononucleosis
Diagnosis of mononucleosis
Infectious mononucleosis is diagnosed based on several analyzes:
Also, a prerequisite for the development of mononucleosis is considered availability of mononuclearov. These cells are found in blood under mononucleosis and their number increased by 10% of the norm. In this case, mononuclears are found not immediately after the start of the disease - as a rule, 2 weeks after infection.
When, on the basis of one blood test, it is not possible to identify the cause of the symptoms, the presence of antibodies to the Epstein-Barra virus is determined. Often prescribe research PCRthat helps get the result quickly. Sometimes diagnosis is carried out to determine HIV infection, which manifests itself as mononucleosis.
To determine the causes of an angina and differentiate from other diseases, consultation of a otolaryngologist is assigned, which makes a pharyngoscopy that helps determine the cause of the disease.
Treatment of mononucleosis
What doctors to contact mononucleosome
The treatment of mononucleosis is symptomatic. Antiviral, antipyretic, anti-inflammatory preparations and tools for improving immunity. Showing application local antiseptics For disinfection of the mucous membrane of the throat.
It is allowed to use an anesthetic spray, solutions for rinse. If there is no allergies on beekeeping products, honey is used. This tool strengthens the immune system, softens the throat and struggles with bacteria.
Infectious mononucleosis is often complicated by viral infections - in this case, antibacterial therapy is carried out. Patients are required to provide abundant vitamined drink, dry and clean clothing, attentive care. Due to liver damage not recommended frequently Take antipyretic agents, such as paracetamol.
With pronounced hypertrophy, the almonds and the threats of asphyxia are prescribed by the prednisolone by a short-term course. In treating it is necessary to refuse From oily, fried dishes, sharp sauces and seasonings, carbonated drinks, too hot food.
Medications
As a rule, the following drugs are prescribed during mononucleosis:
- antipyretic (ibuprofen, paracetamol);
- vitamin complexes;
- local antiseptics;
- immunomodulators;
- hepatoprotectors;
- choleretic;
- antiviral;
- antibiotics;
- probiotics.
Treatment of mononucleosis in children
In the acute period of the disease, in order to avoid injury to an increased spleen (or its gaps), it is important to observe bed regime. The treatment of mononucleosis in children is combined with phytotherapy. In this case, the perfect decoctions.
Take in equal parts of daisy flowers, calendula and immortals, leisure and marriage leaves, yarrow grass and turn. Herbs grind on a meat grinder. Next, take two tablespoons of the mixture and pour the liter of boiling water. The decoction insists in the thermos overnight. Take the infusion for half an hour before the meal of 100 ml.
Children prescribe a special diet that needs to be observed half a year old. At this time, nothing is fattened, smoked, sweet. The patient should use as much as possible:
- milk products;
- fish;
- non-fat meat;
- soups (preferably vegetable);
- puree;
- porridge;
- fresh vegetables;
- fruits.
At the same time, you will have to reduce the use of creamy and vegetable oil, sour cream, cheese, sausages.
After recovery, for 6 months, the child is observed an infectious person in order not to miss complications from the side of the blood. The suffering disease leaves after an imminent immunity.
Instructions for the use of drugs during mononucleosis
Restoration after mononucleosis
When the children hold high temperatures, they eat reluctantly, mostly drink a lot - let it be sweet tea with lemon, non-acidic fruit and compotes, natural juices without preservatives. When the temperature is normalized, the child's appetite is improving. For half a year it is required to comply with the correct diet in order not to overload the liver.
Child after mononucleosis, quickly gets tired, feels broken and weak, it takes more time to sleep. You can not overload the child with home and school matters.
For preventing complications Mononuclease Children need to be abide by some recommendations for six months:
The child needs leisurely walks in the fresh air, favorably affects the recovery after the disease staying in the village or in the country.
Complications of mononucleosis
As a rule, mononucleosis ends full recovery.
But sometimes serious complications happen:
Neurological complications
- polyneuropathy;
- encephalitis;
- meningitis;
- mental disorders.
Hematological complications
- reducing the number of platelets;
- the death of red blood cells;
- reducing the number of white blood cells.
Gap splezen
A serious complication of mononucleosis, accompanied by a decrease in blood pressure, sharp pain in the abdomen and faint.
Causes of mononucleosis
In saliva, the virus is found at the end of the incubation period of the disease, during the period of the rank and sometimes after 6 months after recovery. The selection of the virus is noted in 10-20% of persons, in the past suffering infectious mononucleosis.
How can I get infected with mononucleosis
Even after the suffering disease, the patient continues to allocate the Epstein-Barra virus for a long time (up to 18 months!). This is proven by numerous studies.
Half people endure infectious mononucleosis in adolescence: boys in 16-18 years old, girls in 14-16 years old, in the future the incidence rate drops.
Persons over 40 years old infectious mononucleosis are extremely rare. This does not concern the patients with AIDS or HIV infected, they are sick of mononucleosis at any age, in heavy forms and with severe symptoms.
How not to infect mononucleosis
To improve immunity, regularly make a set of hardware events. Wash cool water, go home by barefoot, take a contrasting shower, gradually increasing the duration of the cold part of the procedure and reducing the water temperature. If doctors do not prohibit, pour in winter with cold water.
Try to lead a healthy lifestyle, give up bad habits. Include in the diet easily visible products with vitamins and trace elements: citrus, dairy and other products. Requires physical education, walking in the fresh air, charging in the morning.
In coordination with the doctor, drugs that increase immunity are adopted. Better vegetable origin, for example, the tincture of Eleutherococcus, ginseng, chinese lemongrass.
Since mononucleosis is transmitted by air-droplet, it is necessary to eliminate contacts with a sick person. People who communicated with him fall within twenty days, counting from the day of the last contact.
If the child visits kindergartenIt is required to carry out a thorough wet cleaning of the room of the group using disinfectants. Sharing items (dishes, toys) are also subject to disinfection.
Other children visiting the same groupIn the prescription of the pediatrician, a specific immunoglobulin is introduced to prevent the disease.
Questions and answers on the topic "Mononuclease"
Hello, the child has a year and a half in the blood of monocytes and atypical mononuclear. Almonds and lymph nodes are increased. There is no rash. The liver and spleen are not enlarged. Can this be infectious mononucleosis? Thank you.
Child a month ago, the mononucleosis fell, lymph nodes were still increased. Temperature then 37, then 36.8
Daughter 11 years old. I got over the mononucleosis a month ago, and the cervical lymph node passes very slowly, as I do not know with it. Help me please!
My son is 5 years old. Very often sick, sometimes a month more than once. A month ago, we were discharged from the hospital after the suffered infection mononucleosis. Today, the temperature of 37.3 rose again and redden her throat. Throughout the month, Cecloferon and Viferon took. What to do to treat now? Please tell me.
Lymph nodes sometimes remain enlarged (not inflamed) for quite a long time. If the child feels fine - everything is fine. Over time will pass. Continue to monitor the temperature and show the child to the doctor if the temperature rises more than 38.5 C.
Tell me, what tests are needed to detect mononucleosis?
I am 29. Three weeks ago, the lymph node was ill and fell ill on her neck on the right side, the next day the same with the left and very echo the throat. After 4 days, the throat passed, a strong cough began and the temperature was raised to subfebrile. After 3 days, the temperature rose to 38, Ceftriaxone was appointed, the temperature rose every day, on the sixth day of the antibiotic began to subsoine to normal values, the lymph nodes came to normal. After 4 days, a subfebrile temperature, after another 2 days a strong edema of the throat and an increase in lymph nodes throughout the body. At the same time, strong sweating at night for two weeks and dry cough. Can it be mononucleosis?
Mononucleosis is diagnosed on the basis of laboratory studies.
I am 62 years old. At the end of July, the throat fell ill - I can't cure so far. Visited the doctor ENT. I passed the tests - Virus Barra - 650. The doctor said that he had once a mononucleus and very low immunity. Finding your site I read that it is impossible to repeated mononucleation disease, then why I can not cure throat. And what doctor to contact me (at the moment, the rinch is alternately by a chamomile, a divorced alcohol infusion of propolis, Tanzelgon and Lugolam) or is it all about immunite? And what do you advise?
If ENT has not prescribed treatment and drew attention to the immune system, you need to contact the immunologist.
Can there be complications on the joints after the mononucleosis moved a month ago?
The seventh day of the child (daughters almost 9 years old) is kept temperatures, the first 4 days rose to 39.5. The first 2 days of the child complained that he hurts and hurts his head, usually the flu is happening with the flu, nothing bothered nothing, began to take the ingenet. The throat turned red for 4 day, but there is no fall and there is no pain, the doctor examined and diagnosed ODS. However, in the evening for 4 days, they called an ambulance, the doctor suspected mononucleosis, the child takes an antibiotic, passed a general blood test, a large number of leukocytes, mononuclears within the norm (as the pediatrician said) increased lymph nodes. On the 7th day (today), blood was handed over to the detection of early antibodies and the virus itself, the result will be ready in 2 days. The doctor gave direction to hospitalization and it worries us very much, since in the infectious department I don't want to be at all with a child. Can you please tell me how much the need for hospitalization is? Worried about the nose (breathing difficult), the runny nose is especially no!
Patients are hospitalized by clinical indications. The main indications for hospitalization and treatment of the patient in the hospital are: long-term high fever, jaundice, complications, diagnostic difficulties.
My child is 1.6 months old. 4 days went away to Nursery and sick with mononucleosis. 7 days was the temperature under 40. We were put in the hospital. Pierced 7 days with antibiotics and continue to drink acyclovir. Now he was pumped acmis. What is allergic or so does the disease manifest? What to do?
In the midst of the disease in patients receiving antibiotics, allergic rash often appears. This is more often observed when prescribing the preparations of a penicillin row. Notify about this attending your doctor.
For 3 years, the child suffered infectious monukleosis after which ORVI is sick monthly. How does monucleosis affect the immune system, what is the most effective treatment and prevention of consequences?
In our opinion, the cause of frequent Episodes of ARVI in a child is not mononucleosis, and the other reason (decrease in immunity), which may have led to the fact that the child has developed mononucleosis. Infectious mononucleosis does not have a long influence on the immune system and does not cause late complications. Immunity is needed to carry out the prevention of ARVI.
Tell me, please, the child was 14 years old by mononucleosis. How to determine whether there is complications? My acquaintances advised to pass blood to AST and Alt. Is it necessary? And is it necessary to take on antibodies to mononuclearam?
How long have your child silence mononucleosome? Did the child examined the doctor? If there are no complaints of a child, there is no yellowing of the scool eyes or skin, then the presence of complications of mononucleosis is practically excluded. No additional analyzes are required for you.
My granddaughter will be 6 years old in December. Diagnosed mononucleosis. High temperatures were not. Now they said that the liver increase by + 1.5-2 cm. What a diet should be?
Diet with mononucleosis is as follows: full nutrition, inclusion in the diet of boiled meat, low-fat varieties of fish, vegetables, fruits, dairy products, porridge. Excluded fried, fatty, sharp dishes.
Boy 15 years old Suspicion of infectious mononucleosis is sick 5 day: severe throat pain, nasal congestion, lack of appetite, severe weakness, headache, high temperature has been held for 4 days (38.7-39,1). I knock down Nurofen (2 days), takes Zinnat (2 days), Tantuum-Verde, Nazivin, Akwalor, rinse. To Nurofen knocked Panadal (2 days). When palpation increased liver, white plaque on almonds (foul. Angina). Why does the temperature continue to hold on? Isn't it harmful to take nourofen for more than 3 days? And how long is the high temperature can hold on? Tomorrow we will surrender urine and blood test.
Increased temperature in infectious mononucleosis can hold for quite a long time (up to several weeks). Noroofen receiving for more than 3 days is not dangerous, but we recommend additionally consult on this topic with the attending physician.
Half a year ago I got infectious mononucleosis. He moved him to her legs, because did not know. Then he only passed the tests on infections and found that I got sick. There was a high temperature, the lymph nodes were enlarged cervical and occipital. After that, I felt fine. The infectious person said that in her treatment I do not need, and why the temperature is why other doctors find out. Now for half a year I have a long sub-service. Malaise. Weakness. In the morning Temperature 35.8, in the evening rises. None of the doctors can say anything. And literally 3 days ago, also bothered. Normal ODS. But it is impossible to sleep at night, the lymph nodes have increased on the back of the head and ear. Now I do not know what it is. What is it connected with. Help me please!!
As a rule, infectious mononucleosis does not require specific treatment and always ends with recovery. The disease almost never occurs again. After recovery, a person is often observed with a weakened immunity and an increased predisposition to other infections. There are many reasons for increasing body temperature, so the diagnosis is possible only with direct contact in the doctor who will find out the presence of other symptoms, and also assign additional research.
Please tell me whether you can make the vaccinations of DC and complete the children (3 and 6 years old) if they have a diagnosis of infectious mononucleosis, "cytomethegalovirus", we have been treating these infections for 2 years, but to no avail. The acute phase is not now. Before that, the immunologist was a medical dismount given once, when the sharp phase was, and hematologist gives a vote all the time. From the kindergarten require either a medical voice or vaccination. I know that these infections are impossible to practically cure, only betray the body to children with medicines. The last time you appointed vitamins (he is constantly inflamed lymph nodes on the neck). Now need a re-examination. But I do not want to go, as I know that the analysis will show the same thing, but the treatment is the same.
In this case can be vaccinated.
How to quickly and effectively raise the immunity of the child after mononucleosis?
Immunity is too complicated and finely organized and therefore from all sorts of too sharp and active influences it can upset.
My 12-year-old son in June suffered a heavy form of mononucleosis. At this time we take cycloferon. Recently, the child began to complain about strong frequent heartbeats. In calm condition without physical Loads Pulse can reach 120 beats per minute at arterial pressure in the range of 120/76 - 110/90. Cases of such strong heartbeat happen even at night. Can these symptoms indicate any complication after the suffering disease? Or is it something else? And what doctor should you contact?
You should show the child to the pediatrician and cardiologist. Despite the fact that the defeat of the heart during mononucleosis is practically excluded, consultation of the cardiologist in this case is still necessary.
Is it possible to get a mononucleosis infectious re-?
My 12-year-old son is sick mononucleosis. Acute stage of the disease passed. Now it is worth a house. I was constantly near the village, practically did not leave. I am 41. Now I felt bad. The temperature is kept 37.3 - 37.8. Strong weakness. The pain in the throat, the nose periodically does not breathe. The feeling that this pain and discomfort wants to move to the ears. Very blushed eyes. Can I now become a carrier of this virus or sick with mononucleosis itself?
The symptoms described by you are not characteristic of mononucleosis and is generally unlikely that you have become infected with this disease from the child. You may have an episode of Banal ARVI, which is common at this time of the year (adenoviri). We recommend to conduct symptomatic treatment of colds folk remedies. If you notice the appearance of pain in the field of the liver, an increase in lymph nodes or any other signs of mononucleosis be sure to consult a doctor.
My 12-year-old son was diagnosed - mononucleosis. The disease occurs hard. The temperature reached the mark of 40.4. Symptoms of this disease remove traditional means. At the moment there is a 6th day of illness. The temperature rests within 38.3 - 39.5. From hospitalization I refuse due to the fact that the child eats exclusively home food. Maintaining this condition in the hospital is not possible, due to the fact that the appetite may occur at any time of the day with a decrease in temperature, even at night. Can I treat this disease, staying at home? What are the risks associated with this disease are possible?
In most cases, infectious mononucleosis in children is favorably, which makes it possible to treat at home, but despite this, you should keep the child under the supervision of a doctor. The most dangerous complication of mononucleosis is the spleen break, so make sure that for some time after recovery the child abstained from active games that can lead to a drop or injury of the abdomen.
What kind of disease mononucleosis and how to treat
With infectious mononucleosis faced everywhere. Even in developed European countries, this disease is registered. Most of the people of young and adolescents are preferably sick of them from 14-18 years old. Much less frequently mononucleosis occurs in adults, as people after 40 years, as a rule, have immunity to this infection. Let's figure it out, mononucleosis - what is the disease and how to deal with it.
What is mononucleosis
Mononucleosis is an acute infectious disease accompanied by a high temperature, lesion of lymphatic nodes, oroglot. A spleen, liver, the composition of the blood varies in the painful process. Mononucleosis (cipher code on the ICD 10) has several more names: monocytic angina, Filatov disease, benign lymphoblastosis. The source of infection and the mononucleosis reservoir is a person with a low-heated disease or carrier of the causative agent.
The causative agent of infectious mononucleosis is the Epstein-Barr virus of the Herpesviridae family. His difference from the remaining herpes viruses is that the cells are activated, and do not die. The causative agent is unstable to the external environment, therefore, under the influence of disinfectants, high temperatures, or during drying, it quickly dies. People infected with the virus allocate it throughout the 6-18 months with saliva.
What is dangerous epstein-barra virus
Viral mononucleosis is dangerous in that immediately after entering the bloodstream attacks in lymphocytes - cells of the immune system. Once upon a time when it is primary infected into the cells of the mucous membrane, the virus remains in them for life, because it is not filled with complete destruction, like all herpes viruses. An infected person, by virtue of life-lifelong finding Epstein-Barra infections, is its carrier to death.
After penetrating inside the immune cells, the virus leads them to transformation, because of which they, multiplying, begin to produce antibodies to themselves and to the effects. The intensity of the reproduction leads to the fact that the cells fill the spleen and lymph nodes, provoking them to increase. Antibodies for the virus are very aggressive compounds, which, hitting the fabric or organ of human dogs, provoke diseases such as:
- Lupus erythematosus.
- Diabetes.
- Rheumatoid arthritis.
- Tareloit Hasimoto.
How is the mononucleosis man
Often infectious mononucleosis is transmitted from the carrier person to a healthy air-droplet or with saliva. The virus can be infected through hands, with sexual intercourse or kiss, through toys or household items. Doctors do not exclude the fact of transferring mononucleosis during generic activity or blood transfusion.
People are very susceptible to Epstein-Barra virus, but erased or atypical mononucleosis (light shape) prevails. Only in the state of immunodeficiency, the infection contributes to the generalization of the virus when the disease passes into the visceral (heavy) form.
Symptoms and signs of illness
The characteristic criteria for the first days of mononucleosis infection is an increase in the size of the spleen and the liver. Sometimes during the disease, a rash on the body, abdominal pain, syndrome chronic fatigue. In some cases, under mononucleosis, liver functions are disturbed, the temperature has been held for several first days.
The disease is developing gradually, starting with an angina and high temperature. Then the fever and rash during mononucleoset disappear, the raids on the almonds pass. Some time after the start of the treatment of mononucleosis, all the symptoms can return. Poor well-being, decay of forces, an increase in lymph nodes, the decline in appetite sometimes lasts several weeks (up to 4 or more).
Diagnosis of the disease
Disease recognition is carried out after a thorough laboratory diagnosis of infectious mononucleosis. The doctor considers the general clinical picture and analyzing the blood of the patient on the CPR (polymerase chain reaction). Modern medicine is able to identify the virus without analyzing the selection from the nasopharynx. The doctor knows how to diagnose and cure mononucleosis according to the presence of antibodies in the blood serum at the stage of the incubation period of the disease.
For the diagnosis of mononucleosis, serological methods are also used, which are aimed at identifying antibodies to the virus. When the diagnosis of infectious mononucleosis is supplied, a three-time study of blood is carried out on the definition of the presence of antibodies to HIV antigens, since this infection at the initial stage of development also sometimes gives symptoms of mononucleosis.
How to treat mononucleosis
The disease with a light or mid-heavy stage is quite treated at home, but the patient is isolated from the rest. With severe mononucleosis, hospitalization is required, at which the degree of intoxication of the body is also taken into account. If the disease proceeds against the background of lesion of the liver, the hospital is appointed therapeutic diet number 5 in the hospital.
Specific methods of treatment of mononucleosis of any etiology today does not exist. Medics, after studying the history of the disease, symptomatic therapy is carried out, in which antiviral drugs, antibiotics, disinfecting and tall drugs are prescribed. Must be assigned to rinse the rotogling by antiseptics.
If bacterial complications are absent during mononucleosis, then antibiotic treatment is contraindicated. If there are signs of asphyxia, if the tonsils are increased strongly, the course of treatment with glucocorticoids is shown. Children after restoring the body for another six months it is prohibited to make preventive vaccinations in order to avoid the appearance of complications of mononucleosis.
Medical treatment: drugs
Infectious mononucleosis even with the complete absence of treatment can pass independently with time. But that the disease has not moved to chronic stagingThe patient is recommended to carry out therapy not only by folk remedies, but also medication. After applying to the doctor, the patient under mononucleoset is assigned pastel mode, a special diet and the reception of the following medicines:
- Acyclovir. Antiviral drug reducing the manifestation of the Eppache Barra virus. In mononucleosis, an adult is prescribed 5 times / day of 200 mg. It should take it for 5 days. Children's dose is exactly half of the adult. When pregnancy, treatment is prescribed in rare cases under strict medical supervision.
- Amoxiclav. With infectious mononucleosis, this antibiotic is prescribed if the patient has an acute or chronic form of illness. Adults need to take a day to 2 grams of medication, teenagers - up to 1.3 g. Children under 12 years old dosage appoints a pediatrician individually.
- Supraq. A semi-synthetic antibiotic, which is prescribed with infectious mononucleosis once a day. Adults assume a disposable dose of 400 mg (capsules). The course of medication during the disease lasts from 7 to 10 days. For children (6 months - 2 years), the mononucleosis uses a suspension at a dose of 8 mg per 1 kg of weight.
- Viferon. Antiviral immunomodulator, increasing immunity. At the first signs of mononucleosis, a gel or ointment is prescribed for use (outer) on mucous membranes. The drug is applied during the illness to the affected area within a week to 3 times / day daily.
- Paracetamol. Analgesic, which has antipyretic and anti-inflammatory effect. Prescribed with the acute form of mononucleosis to patients of all ages (headache, fever) of 1-2 table. 3 times / day 3-4 days. (See detailed instructions for the use of paracetamol).
- Faringosept. An analgesic means to help remove the throat with mononucleoset. Prescribed, regardless of age, 4 absorbing tablets per day. Take the drug no more than five days in a row.
- Cycloferon. Immunomodulating and antiviral medicine, effective with herpes virus. Suppresses its reproduction in the earliest 1 mononucleosis (from 1 day). Children under 12 years old and adult patients are prescribed inside 450/600 mg daily dose. For children from 4 years, the daily reception is 150 mg.
Treatment of mononucleosis by folk remedies
To cure mononucleosis by natural means, but there is a risk of different complications. Reduce the course of the disease and facilitate the symptoms will help the following folk recipes:
- Floral decoction. Take in the same doses. Freshly placed or dry daisy flowers, sage, calendula. After stirring, pour boiling water, insist 15-20 minutes. To increase immunity and reduce liver intoxication during infectious mononucleosis, drink 3 times a day 1 cup (150-200 ml) of the beam before improving the condition.
- Herbal decoction. To reduce the sore throat in case of infection, it is cooled every 2 hours a decoction of chopped rose hips (1 tbsp. L.) And dry chamomile (150 g). Brew the ingredients in the thermos for 2 hours, after which you have the throat until complete recovery.
- Capprade. Vitamin C, which is in large quantities in white cabbage, will help rapid recovery and remove fever. Boil cabbage leaves 5 minutes, after the decoction, insist before cooling. Each hour take 100 ml of cabbage beam until the fever ceases.
Medical diet
As already mentioned, the liver is amazed at infectious mononucleosis, so during the disease it is necessary to eat right. Products that the patient should use during this period should be enriched with fats, proteins, carbohydrates and vitamins. Food reception is prescribed fractional (5-6 times / day). During the medical diet, the following products are needed:
- low-fat milk products;
- lean meat;
- vegetable puree;
- fresh vegetables;
- sweet fruits;
- fish soups;
- non-fat sea fish;
- seafood;
- some wheat bread;
- porridge, pasta.
During the medical diet, give up the creamy and vegetable oil, cheese of solid varieties, fatty sour cream, sausages, sausages, smoked. It is impossible to eat marinades, pickles, canned food. Smaller to eat mushrooms, cakes, cakes, horseradish. It is strictly forbidden to eat ice cream, onions, coffee, beans, peas, garlic.
Possible complications and consequences
The mononucleosis infection is firmly ends very rarely, but the disease is dangerous by its complications. Epstein-Barr virus has oncological activity for another 3-4 months after recovery, so during this period you can not be in the sun. After the disease, the lesion of the brain is sometimes developing, inflammation of the lungs (bilateral) with severe oxygen starvation. It is possible during the illness to break the spleen. If the child has a weakened immunity, mononucleosis can lead to jaundice (hepatitis).
Prevention mononucleosis
As a rule, the disease forecast is always favorable, but symptoms of mononucleosis similar to many viruses: hepatitis, angina and even HIV, so at the very first signs of the disease, please contact the doctor. To avoid infection, try not to eat from someone else's dishes, if possible, not kissing in the lips once again not to swallow the contagious saliva. However, the main prevention of the disease is a good immunity. Vedi correct image Life, load the body physically, take healthy food, and then no infection will win you.
Mononucleosis in children most often appears aged two to fifteen years. This is an infectious disease that is likely resembles flu or angins, but also affects internal organs. It is transmitted by air-droplet, and the pathology is maintained for a lifetime, and when the immunity is reduced, it is capable of recurrence. In severe cases, when the infection is not detected, it is capable of leading to death.
The flow and form of the disease
There is a virus in the mucous membrane oral cavity , then he striking almonds and throat. After that, by circulating blood and lymph, the infection falls into the internal organs, affecting many internal organs. As a rule, pathology proceeds without complications, they occur only if there is relapse when weakening immunity. Symptoms of mononucleosis in children, during repeated pathogens microflora, proceed with inflammation of the lungs, begins sinusitis and the eud.
In the first infection, the incubation period lasts from five days and up to three weeks, and when the disease passes into a difficult form, the duration increases from 2 to 4 weeks. In case of untimely treatment, the mononucleosis virus goes into a chronic form. Then the child becomes constantly increased lymph nodes, the hearts, brain and nerve centers may occur, as a result of this, the facial expressions are disturbed, frequent psychosis arise.
Infectious mononucleosis in Children Komarovsky divides on forms:
- Typical. Proceeds with pronounced symptoms. The child begins an agnus, heat, the liver and spleen increase.
- Atypical. Symptoms of the disease are either completely absent, or manifest in the form of heart disease, nervous system, and light and kidney are affected.
Pathology can flow in a smooth form, not complicated, complicated or protracted. In order to prevent the baby's infection, it is necessary to strengthen the immunity from birth.
Ethiology of the emergence of a few
The main reason for the appearance of the disease is infection with infection. Main paths of infection by mononucleosis:
- Happens after kisses with a contagious man.
- Contact with patients.
- Use of one kitchenware, clothing, bed linen with infected.
In addition, the disease is transmitted by air-drip, a person is enough to sneeze or dance, and the causative agent of the ailment enters the environment. Most often infection occurs from schoolchildren and children preschool age, Less often arises mononucleosis in infants. If the infection has appeared in a newborn, it means that there are no deeds from the mother during pregnancy through blood. Based on statistics, the boys are much more often the disease than girls.
Symptoms and signs of illness
After contact with the infected person, it is necessary to follow the state of the baby in the next three months. If the disease did not show itself, it is believed that the infection has not happened, the immunity will overcome the virus, or the disease proceeded asymptomatic. To the mainstream symptoms of infectious mononucleosis in children include:
The mononucleosostile syndrome is similar to the symptoms of Angina, but the main difference is that the throat is also joined in the soreness of the throat. In addition, elevated content of mononucleararies arises in the blood, which can be installed only with medical analysis.
At all young children, the mononucleosostile syndrome manifests itself weakly, and it is quite difficult to distinguish it from ORVI. The main distinguishing feature at one year old children is the appearance of rash, they have more often than more adult kids.
Children from six to fifteen years are manifested by syndrome more brightly. As a rule, when children only appear signs of fever, it means that the body struggles with infection.
Diagnostic events
In order to distinguish mononucleosis from another disease and assign correct treatment, the specialist appoints diagnostics. Blood fence to perform the following types of analysis:
Since mononuclears occur in the blood in children and with other diseases, the analysis of antibodies to other types of infections is necessarily taken. In addition to basic analyzes, a specialist issues a direction on the ultrasound of internal organs to exclude their increase.
Many parents for the first time hear the diagnosis of infectious mononucleosis or monocytic angina, when they turn to a doctor with their sluggish temperature chance, although they themselves probably got it at first glance "terrible ailment."
Mononuclease - what is it? How can a child get infected with infection?
In 1963, English biologists M. Epstein and I. Barr examining the sample of the lymphoma of Berkitta, discovered a virus, which is able to cause a "ferrous fever", described by N. F. Filatov in 1886 - inflammation of lymphoid tissue.
The brightest symptoms of this ailment are an increase in spleen, liver and cervical lymph nodes. A little later, scientists with the doctors of our country were discovered that in patients with "hardware fever" change white blood tales (leukocytes) - the formation of atypical mononuclears.
Since then, the name has appeared, which is used in modern medicine - infectious mononucleosis . In recent years, many experts suggest that Epstein-Barr virus plays a etiological role in the origin of this disease.
Mononucleosis is not included in the group of particularly infectious infections, so the epidemics does not cause.
The transmission paths of the virus are diverse, however, a close contact with infected saliva is required for 100% of infection.
- Common toys.
- Kisses.
- Dishes.
- Household items.
Children from 3 to 10 years are considered the most common age group in the incidence of these viral diseases. In many cases, the disease occurs in a light form for which the low temperature is characterized and increased fatigue. Such a state does not cause special anxiety from the parents, and the kid itself recovers. However, in the adolescence, the disease occurs in a more severe form.
Komarovsky about infectious mononucleosis on video
Symptoms and signs of mononucleosis in a child - how to recognize the disease?
The causative agent of infection falls into the body of the baby through the respiratory organs and is in the "dormant" state of about 10 days. Many pediatricians notice that the boys have almost twice as more than girls.
In 40% of cases, the disease can pass without clinical symptoms, the remaining 60% of the disease manifests itself:
- Sore throat when swallowing.
- Lack of appetite.
- Nasal mortgage.
- Nausea.
- Head and muscular pain.
- Fever.
- Herpes rashes on the skin.
- Puncelness of eyes and abrasion arcs.
- High fatigue.
- Abdominal pain.
- An increase in lymph nodes.
- Bleeding gums.
- An increase in the spleen and liver.
- Jaundice.
- The appearance on the almonds of a gray laid with an unpleasant smell (mononuclear angina develops).
In some cases, the disease flows sluggishly and has a protracted character - parents can alert permanent drowsiness, child apathy and high susceptibility to other infections.
What needs to pass the tests to the child to confirm the mononucleosis virus?
The complexity in the diagnosis of infectious mononucleosis is considered to be the similarity of its clinical manifestations with other bacterial and viral pathologies:
- Diphtheria.
- Acute leukemia.
- Rubella.
- Lymphogranulomatosis.
To confirm the presence of a virus, the following laboratory surveys must be carried out:
- Clinical analysis of blood counting leukocyte formula - An increase in the amount of lymphocytes and the presence of wide-plasma atypical mononucleararies will confirm the diagnosis of mononucleosis.
- Biochemical analysis - An increase in the concentration of bilirubin and hepatic enzymes of alosy and astes in the blood is characteristic of this disease.
- Research of saliva or nasopharynx washouts to identify Epstein-Barr virus .
- Genetic research of blood - To determine the DNA of the virus.
- Immunogram - To assess the condition of the child's immune system.
- Test for heterophilic agglutinins - To confirm the viral etiology of the disease.
Features of the treatment of children with mononucleosis
There is no specific treatment of the virus - symptomatic, constructive and desensitizing therapy, including:
- Bed regime and cancellation of the patient's visits.
- antipyretic drugs.
- - Nasal washing and the use of vesseloring agents.
- Gargling - soda (1 teaspoon on 250 ml of water) and salt (1 tsp. At 400 ml of water) solutions, chamomile decoction and sage.
- Reception of multi-vitamins and immunostimulating funds.
- Compliance with a gentle diet - Limit smoked, oily, fried and sweet food. Bean, nuts and ice cream are prohibited. It is desirable to eat soups, boiled fish and meat, porridge, fresh vegetables and fruits, low-fat dairy products.
It is important to know - during treatment, physiotherapy procedures, compresses and rubbing are prohibited!
Antibacterial agents are used when attached microbial flora - Streptococcal, staphylococci, pneumococci only after consulting with the attending physician. Heavy forms of the disease are treated with a short course of glucocorticoid drugs.
Within 6 months, it is necessary to regularly pass tests - monitor blood formula and hepatic enzymes, comply with the diet, avoid mass events, physical exertion, planned vaccines, and travel to the sea - the virus "like" moisture and heat.
Consequences of infectious mononucleosis and possible complications
Usually, any form of the course of the disease ends with complete recovery and the acquisition of lifelong immunity to the virus.
However, there may sometimes develop complications of illness that end:
- Weakening immunity and susceptibility to bacterial infections.
- Angina.
- Otitis.
- Mental and neurological disorders.
- Encephalitis.
- Meningitis.
- Poly-neuropathy.
- Pneumonia.
- The separation of the spleen - at the same time there is a sharp abdominal pain, the pressure is reduced, the loss of consciousness is possible.
- Hepatitis.
- Hematological complications - the number of leukocytes and platelets decreases, erythrocyte death occurs.
In very rare cases, it is possible to overlap the upper respiratory tract by inflamed almonds and the lung infiltration, which will lead to oxygen starvation.
Most an important point It is that the Epstein-Barr virus, causing infectious mononucleosis, is considered an oncogenically active (capable of stimulating the occurrence of cancer pathologies). That is why parents must trace the restoration of the normal blood formula - widely plasma mononuclears gradually disappear.
If this does not occur for a long time - it is necessary to refer to the help of a qualified blood disease specialist (doctor-hematologist).
Prevention of the disease
Unfortunately, vaccines from this virus do not exist, but there are some events that will reduce the likelihood of infection:
- Teach kids to wash the handles with soap.
- Do not eat or drink from your dishes to other kids.
- Do not lick other people's toys.
It is important to stop communicating with children sick mononucleosis and observe the behavior and well-being of your child.
If he is plain, it urins little, complains of severe pain in the tummy - urgently show the kid to Dr.!
Infectious mononucleosis in children is viral disease With the preferably damage to the organs of the reticulosendothelial system (including the spleen and the liver) generated by lymphadenopathy and changes in white blood cells (lymphocytes). The disease is known since the 19th century. The second name of the infection is the "Filatov disease", by the name of the doctor first described it.
Cause and prevalence of the disease
It has been established that infectious mononucleosis in children is caused by a six-type herpetic virus (its name of Epstein-Barra virus). Once upon a time getting into the body, the virus in it remains forever. It does not depend on whether the clinical signs of mononucleosis in children after infection or infected child became an asymptomatic viroster.
It has been established that among children under 5 years old is infected with the Epstein-Barra virus every second child. And the infection of the adult population is about 90%.
In a state of rest, the virus is in lymph nodes, and with a decrease in immunity under the influence of any adverse factors, the virus is activated and causes recurrence of the disease.
Outside the body, the virus is not stable, quickly dies, it is impossible to be called highly contagiaous. Therefore, it is necessary to infect enough close contact with the patient or a virus carrier, which are a source of viral infection.
Infectious mononucleosis in children often occurs up to 10 years. The incidence is higher in the autumn-winter-spring period. Girls are ill in 2 p. less often than boys.
The selection of the virus occurs with droplets of saliva or nasophacks. An air-droplet infection is distributed during sneezing, cough, kisses. It is possible to infection through the common utensils. Finding into the rothoglotka, the virus affects the epithelium cells, penetrates blood and is entered into lymph nodes.
Do you need quarantine?
When a patient with infectious mononucleosis (adult or a child) is spoken by infectious mononucleosis (adult or child), it is quite difficult to avoid infection. This is due to the fact that even after recovery remains forever with viruses, and can periodically allocate the virus into the environment. Therefore, it makes no sense in the isolation of the child, he can attend school or kindergarten after recovery.
Symptoms
With mononucleosis, the child has the incubation period more often than 5-15 days (but it can last to 3 months). It is up to 3 months. It should be closely monitoring the condition of the child if the fact of contacting it with a patient mononucleosis has become a famous fact. The lack of signs of infection for this period may mean that infection was not, or there was an asymptomatic form of the disease.
Symptoms of mononucleosis in children at the beginning of the disease reflect general intoxication of the body in combination with catarrhal manifestations.
These include:
- general weakness;
- nasal congestion,
- fever;
- sore throat;
- redness and increase almonds.
Then appear on the background of intoxication The main clinical manifestations of mononucleosis:
- rashes on skin cover;
- the lesion of the almonds of the Occillary Ring;
- an increase in lymph nodes;
- increased spleen and liver.
The nature of fever and the duration of its depend on the individual characteristics of the body. It can be subfebrile (within 37.5 0 c), but can reach and high numbers (up to 39 0 s). The period of fever can continue for several days, and can stay up to 6 weeks.
The body rashes are more likely to appear simultaneously with the advent of fever and the increase in lymph nodes.
The rash is distributed throughout the body. According to the nature, the rash is pleasing, reddish, without itching. The appearance of the itch may indicate the allergic nature of rash. The rash disappears on its own, without treatment, as the child recovers.
An important symptom for diagnosis is to increase all groups of lymph nodes, especially cervical. When dying the lymph nodes are sensitive, but there is no special pain. Lymph nodes increase on both sides. They are movable, not smeared with skin.
In some cases, increased lymph nodes in the abdominal cavity cause abdominal pain due to the squeezing of nerves, and the symptom complex is developing, called "acute stomach". In some cases, children even come to the operating table for diagnostic laparatomy.
The constant sign of mononucleosis is the defeat of the almonds. They are enlarged in size, loose, bugs. On the surface of the almonds on the background of redness, raids (islands or films) of white or grayish color are formed, easily removed by the spatula. The mucous after removal does not bleed.
No less important symptoms of mononucleosis are labored liver and spleen. At the same time, there is an unpleasant feeling in the left hypochondrium, pain in feeling the abdomen to determine the size of the spleen.
The sizes of the spleen and the liver continuously continue to increase over 2-4 weeks of the disease, HA may remain increased after improving the well-being of the child and clinical recovery. After the disappearance of fever, the liver and spleen is gradually come back in size.
In the hard case, the spleen capsule does not withstand the voltage at an increase in the organ and is broken, which is a severe complication of the disease.
When the spray of the spleen appears such symptoms:
- nausea;
- damage in the eyes;
- dizziness;
- vomiting;
- sharp weakness;
- growing spilled abdominal pain.
In addition to typical development and manifestations of the disease, atypical forms of mononucleosis may occur:
- With atypical mononucleosis in children, signs of illness can be expressed stronger than usual or, on the contrary, some signs are completely absent (for example, temperature). Atypical forms more often cause severe complications and consequences of the disease in children.
- One of the atypical forms is the lightning system, in which the manifestations of the disease, the symptoms of intoxication appear suddenly and violently increase over several days. At the same time there is a high fever with chills, headache, sharp weakness, muscle pain, throat pain.
- Chronic mononucleosis with periodic recurrences is developing with a decrease in immunity in a child.
The diagnosis is set with such data:
- transferred over the last 6 months. Primary mononucleosis, confirmed by high titers of specific antiviral antibodies;
- detection of epstein-barra virus particles in the affected tissues using an immunofluorescent method;
- characteristic diseases (increasing spleen, persistent hepatitis, generalized increase in lymph nodes).
Diagnosis of mononucleosis
Support signs for clinical diagnosis of mononucleosis are hyperplasia lymph nodes, spleen and liver, fever. Diagnosis of mononucleosis is quite complicated. A number of other severe diseases with similar symptoms (leukemia, lymphoganunomatosis, bacterial angina, diphtheria, viral hepatitis) should be excluded.
For differential diagnosis The manifestations of tonsillitis during mononucleosome from the bacterial threshing is carried out a laboratory study of the smear from the oz to the pathogenic flora (by bacteriological and bacterioscopic research) and diphtheria.
Hematological changes in clinical blood study are important. Confirmation of the mononucleosis is the detection in the blood of atypical mononucleararies more than 10%. But they appear only for 2-3 weeks of illness.
In some cases, the hematologist is needed and the analysis of sternal puncture to eliminate blood diseases (leukemia, lymphoganunomatosis). The study of blood for HIV is also being carried out, as it can also provoke the appearance of mononuclears in peripheral blood.
To clarify the diagnosis of serological examination of blood to determine the titer of antibodies of class M antibodies (in early terms) and class G (at a later period). A virus Epstein-Barr in dynamics.
Accurate and highly sensitive (besides fast) is the detection of Epstein-Barra virus with PCR.
Biochemical study of blood, an immunofermental blood test for antibodies to hepatitis viruses, ultrasound will help to eliminate viral hepatitis.
How to treat mononucleosis in children?
In case of infectious mononucleosis in children, symptoms and their treatment depends on the degree of severity. More often, the treatment of infectious mononucleosis in children is carried out at home. Only children with severe disease are hospitalized.
Indications for hospitalization are:
- high fever;
- pronounced intoxication syndrome;
- the threat to the development of complications.
Antiviral preparations (acyclovir, cycloferon, interferon, viriferon) do not have a pronounced therapeutic effect, do not affect the severity and duration of the disease. There is no tangible therapeutic effect and from the use of immunomodulators (IRS 19, IMUDON, etc.).
Symptomatic treatment is carried out:
- Antipyretic drugs: NSAIDs are used more often, which not only reduce the temperature, but will be anti-inflammatory effect (paracetamol, ibuprofen, nurofen).
- Antibiotics for the treatment of an angina or an associated bacterial infection. It is better to use macrolides or cephalosporins, since the antibiotics of a penicillin row with mononucleosis are caused by 70% cheerful. Allergic reactions.
- When conducting antibiotic therapy, probiotics and prebiotics are prescribed simultaneously to prevent the development of dysbiosis (acipol, lactobacterin, bifiform, napine, etc.).
- Desensitizing drugs, removing the allergic mood of the body (Loratadine, Tueva, diazoline).
- In case of severe mononucleosis, hyperstoxic forms is carried out by a short course treatment with corticosteroids (prednisone for 5-7 days).
- With pronounced intoxication, disintellation therapy is carried out in the development of hepatitis - the introduction of solutions in the form of intravenous infusions.
- Hepatoprotectors (Essence Forte, Energy, Gearsil) are used in the development of hepatitis. Diet No. 5 is appointed (the exclusion of spicy, fried, oily food, the rational broths, smokers, the seasonings and the filling, sauces, pickles, canned products, fresh baking, beverages with gas).
- Vitaminotherapy (C, RR, Group B).
In the event of the threat of asphyxia and the edema, the larynx is carried out tracheotomy, translation to IVL. When breaking the spleen, an emergency operational treatment is necessary (removal of the spleen).
Forecast and outcome
With timely handling and examination to eliminate blood diseases (leukemia), the outcome of the mononucleosis in children is favorable. But children need to follow the observation and control of blood tests.
Possible consequences after mononucleosis in children:
- Long subfearing temperature (yen 37.5 0 s) for several weeks.
- Lymph nodes are normalized in size within a month.
- Weakness and increased fatigue can be occurred until six months.
Personal children need to observe a pediatrician or infectiousnessist 6-12 months. With mandatory control of blood test.
Complications for mononucleosis are rarely developed.
The most frequent of them are:
- hepatitis (inflammation of the liver), for which, in addition to increasing the size of the liver, is characterized by the appearance of jaundice coloring of the skin and mucous membranes, the dark color of urine, the increased activity of the liver enzymes in the blood test;
- the division of the spleen (develops in 1 challenge. out of the thousand) is dangerous internal bleeding, which can cause fatal outcome;
- serous meningoencephalitis (inflammation of the substance of the brain with shells);
- asphyxia due to pronounced edema of the larynx;
- interstitial pneumonia (lung inflammation).
There is evidence of the inclination after the underwent mononucleosis to the development of oncopathology (lymphoma), but this is quite rare diseases developing in violation in the immune system.
Specific mononucleosis prevention has not been developed.
Infectious mononucleosis occurs in a light form, which is not always diagnosed. With a moderate and serious flow, a thorough examination of the child is required (including mandatory hematologist consultation) and long-term observation of the doctor after the suffering disease, so as not to miss the development of complications and remote consequences.
When the child appears on the light, his immunity begins to "study" all the surrounding dangers. So, gradually, facing those or other viruses, which on the planet several hundred, protection is produced in the form of antibodies to viruses.
Infection by some agents is difficult not to notice, and some diseases pass unnoticed or almost imperceptibly for the parents of the crumbs. Quite often, many moms and dads do not even suspect that the child has suffered infectious mononucleosis. Yevgeny Komarovsky's authoritative doctor tells whether it is possible to determine the symptoms of this disease in Chad, and what to do if the diagnosis was confirmed.
About illness
Infectious mononucleosis - ailment viral. It causes his Epstein-Barr virus, which belongs to common agents and is, in fact, the fourth herpes virus. This "elusive" virus is much more often in contact with the population of the planet than may seem like people themselves, as a result, more than 90% of adults have become infected with them ever. This is evidenced by the presence of antibodies in the blood.
Similar antibodies telling that infection was, immunity produced, are approximately 45-50% of children aged 5-7 years.
The virus feels perfectly in certain cells of the human body - lymphocytes. There, it is quickly replicated with appropriate circumstances that relate to himself, to which a weakened immunity belongs. Most often, the virus is transmitted with physiological fluids - saliva, for example, for this, its infectious mononucleosis is often called "ailment from kisses". Less frequently, the virus is transmitted by air-droplet.
The pathogen is transmitted when transfusion of blood, transplantation operations of organs and bone marrow, as well as from a pregnant mother's fetus through common circulation.
Infectious mononucleosis refers to acute viral diseasesHe does not have a chronic form. From the affected lymph nodes, the virus quickly spreads through the body, hitting the internal organs with lymphoid tissue in its structure.
Symptoms
Komarovsky about treatment
Disease cannot be called fleeting. The sharp phase lasts from 2 to 3 weeks, some have a little longer. The well-being of a child, of course, at this time will not be the best, and sometimes quite heavy. It is necessary to gain patience, because the infectious mononucleosis passes in all children without exception.
Uncomplicated mononucleosis does not require any special treatment. If the child feels good, then nothing but is not necessary to give. If the condition of the crumbs is disappointing, then the doctor can prescribe hormonal anti-inflammatory drugs. The drugs from mononucleosis, as such, does not exist, so the treatment must be exclusively symptomatic: the throat hurts - rinse, does not breathe the nose - bury the saline solution, moisturize the mucous membranes of the bronchi to avoid complications from the respiratory system.
In reception antiviral tools Komarovsky does not see expediency, because they will not have any action on herpes virus 4, but will "hit parents" significantly. In addition, with clinically proven effectiveness antiviral drugs Everything is quite afraid. For the same reason it makes no sense to give a child homeopathic drugs with the stated antiviral action. Harm from them, of course, will not be none, but also the benefit is also not worth waiting.
Treatment should be based on the creation of favorable conditions contributing to the speedy independent recovery of the child:
- In the acute stage of illness, the baby needs peace, bedding;
- The child must breathe moisturized air (relative humidity in the room - 50-70%);
- It is necessary to provide abundant warm drink throughout the acute period;
- Make a wet cleaning in the child's room more, while not using household chemicals with chlorine;
- At high temperature, the child can give "paracetamol" or "ibuprofen".
When the temperature becomes normal, it is possible and you need to walk more often in the fresh air, while refraining from visiting the playgrounds, places of mass accumulation of people, so that the child has infected others and not "picked up" another infection for a weakened immunity himself.
During treatment, it is worth holding a healing diet, excluding all fatty, fried, smoked and salty products from the diet of the child, as well as sharp, sour and sweet. In the acute stage with difficulty swallowing, it is best to give vegetable soups, mashed potatoes, dairy cashie-smear, cottage cheese. In the stage of recovery, it is not necessarily all food to turn into a puree, but the prohibition of the products mentioned above remains in force.
If the bacterial complications joined the mononucleosis, it is possible to treat them only with antibiotics. Parents should be known that if the doctor appoints Ampicillin or popular in Pediatrics "Amoxicillin", then a child with a probability of 97% will appear rash. Why such a reaction occurs, medicine is still unknown. With confidence, it is only possible that this rash will not be allergic to an antibiotic, nor a symptom of a separate disease or complication. She just appears and then passes independently. It should not scare it.
On the fact of the disease of the infectious mononucleosis, parents must inform the pre-school institution, which is visited by Chado, or to school. But this ailment does not require the introduction of quarantine. Just in the premises will need more frequent wet cleaning.
Restoration after suffering infectious mononucleosis - the process is quite long, immunity is strongly weakened. For the next year (sometimes half a year), the attending pediatrician cancels such a child all calendar vaccinations. The child is not recommended for a long stay in close children's teams. The baby should not be treated to the sea to "correct" his immunity, because heavy acclimatization after the transferred viral ailment is guaranteed. During the year, it is not recommended to walk in the sun, attend sections where there is a strong physical activity.
Support the body in the recovery process should be vitamin complexes allowed by age.
The child after the suffering disease should be shown to the doctor more often. The virus has oncogenic activity, that is, may contribute to the development of cancer tumor diseases. If after a disease for a long time in the blood tests, the kid continues to find the most modified mononuclear cells, the child will definitely be shown and put pressure on the hematologist.
An infectious mononucleosis has been produced by a resistant lifetime immunity after transferring a virus. It is impossible to get sick. Exceptions are only HIV-infected, they can have any episodes of acute disease.
