Infectious mononucleosis is a severe form of treatment. What kind of disease is mononucleosis and how to treat it

Mononucleosis- an acute infectious disease characterized by damage to the reticuloendothelial and lymphatic systems and occurring with fever, tonsillitis, polyadenitis, enlarged liver and spleen, leukocytosis with a predominance of basophilic mononuclear cells.

Infectious mononucleosis called Epstein-Barr virus(DNA-containing virus of the genus Lymphocryptovirus). The virus belongs to the herpesvirus family, but unlike them, it does not cause the death of the host cell (the virus mainly multiplies in B lymphocytes), but stimulates its growth.

Becomes a reservoir and source of infection sick person or carrier of infection. An infectious disease specialist treats mononucleosis. Epstein-Barr viruses persist in latent form in B lymphocytes and in the epithelium of the oropharyngeal mucosa.

What is mononucleosis

Infectious mononucleosis occurs everywhere, affecting people of all age groups. In developed countries, the disease is registered mainly among adolescents and people young, peak incidence falls on 14-16 years for girls and 16-18 years for boys. IN developing countries Children of younger age groups get sick more often.

Rarely, infectious mononucleosis occurs in adults over 40 years of age, because most people at this age are immune to this infection. In children under 2 years of age, the disease is usually not diagnosed due to its latent course. Infectious mononucleosis slightly contagious: Mainly sporadic cases, occasionally small epidemic outbreaks.

Symptoms of mononucleosis

Disease develops gradually, starting with fever and severe sore throat: sore throat occurs. Patients complain of poor health, loss of strength and loss of appetite. It is typical that smokers lose the desire to smoke.

The cervical, axillary and inguinal lymph nodes gradually enlarge and swelling becomes visible. Inflammation cervical lymph nodes (cervical lymphadenitis), as well as tonsillitis, are classified as typical signs infectious mononucleosis.

Enlarged lymph nodes are elastic and painful on palpation. Sometimes body temperature reaches 39.4–40°. The temperature remains at a constant level or changes in waves throughout the day, dropping at times (in the morning) to normal. When the temperature rises, headaches are observed, sometimes severe.

From the first days of illness sizes increase liver and spleen, reaching a maximum at 4-10 days. Sometimes dyspeptic symptoms and abdominal pain are observed. In 5-10% of patients, mild icterus of the skin and sclera occurs.

Other symptoms also appear:

• jaundice;
• skin rash;
• stomach ache;
• pneumonia;
• myocarditis;
• neurological disorders.

In some cases, an increase in transaminase activity in the blood is detected, which indicates liver dysfunction. At the height of the disease or at the beginning of the convalescence period in patients receiving antibiotics, allergic rash(maculopapular, urticarial or hemorrhagic). This happens most often when prescribed drugs penicillin series , as a rule, ampicillin and oxacillin (antibodies to them are found in the blood of patients).

The disease continues 2-4 weeks, sometimes longer. At first, fever and plaque on the tonsils gradually disappear, later the hemogram and size normalize lymph nodes, spleen and liver.

In some patients, a few days after a decrease in body temperature, it rises again. Changes in the hemogram persist for weeks and even months.

Symptoms of mononucleosis in children

Children complain of the following symptoms:

• lack of appetite;
• nausea;
• headache;
• chills;
• pain in sacral region, in the joints.

Then laryngitis appears, dry cough, sore throat, and fever. In that early period, the disease is diagnosed as influenza. In some children, these symptoms disappear after a few days. Careful clinical observation notes enlargement and tenderness of the cervical lymph nodes. Other children develop the classic picture of the disease after this period.

Important: Sometimes the course of mononucleosis becomes acute. The child develops chills and fever reaches 39°-40°. The elevated temperature lasts for 7-10 days, and sometimes longer. Often this is accompanied by symptoms from the nasopharynx.

The latter in some children occurs without any peculiarities (catarrh of the nose or throat), in others - tonsillitis, which sometimes takes on an ulcerative and even diphtheria character. Changes in the throat and tonsils become the gateway to secondary infection, sometimes occurring septically.

A typical symptom of mononucleosis is rash on the roof of the mouth. In addition, in addition to the symptoms of sore throat, some children experience swelling of the soft palate, uvula and larynx, as well as swelling of the oral mucosa. The gums soften, bleed, and ulcerate.

Sometimes inflammation of the cornea and mucous membrane of the eyelids occurs. Temperature stays 10-17 days, in some cases up to a month. Sometimes lasts for months low-grade fever.

A characteristic sign of this syndrome is an increase in lymph nodes, mainly in the cervical and nodes located behind the sternocleidomastoid and submandibular muscles (75% of cases), less often in the inguinal and axillary (30% of cases), sometimes in the occipital and elbow. The mesenteric nodes and mediastinal nodes may also enlarge.

Nodes enlarge either singly or in groups. As a rule, the nodes are small, elastic, painful when pressed, which often occurs in the cervical nodes and then only if there are large changes in the tonsils. Rarely does symmetrical enlargement of nodes occur. Abdominal pain, nausea, vomiting and diarrhea are associated with enlarged mesenteric nodes.

Descriptions of mononucleosis symptoms

Diagnosis of mononucleosis

Infectious mononucleosis is diagnosed based on several tests:

Also prerequisite the development of mononucleosis is considered presence of mononuclear cells. These cells are found in the blood during mononucleosis and their number is increased by 10% of normal. However, mononuclear cells are not detected immediately after the onset of the disease - usually 2 weeks after infection.

When one blood test fails to identify the cause of symptoms, the presence of antibodies to the Epstein-Barr virus is determined. Tests are often ordered PCR, which helps to get results quickly. Sometimes diagnostics are performed to determine HIV infection, which manifests itself as mononucleosis.

To determine the causes of a sore throat and differentiate it from other diseases, a consultation with an otolaryngologist is scheduled, who performs a pharyngoscopy, which helps determine the cause of the disease.

Treatment of mononucleosis

sick light and medium-heavy forms of infectious mononucleosis are treated at home. The need for bed rest is determined by the severity of intoxication.

Which doctors should I contact if I have mononucleosis?

Treatment of mononucleosis is symptomatic. Antiviral, antipyretic, anti-inflammatory drugs are used drugs and means to enhance immunity. Application shown local antiseptics to disinfect the mucous membrane of the throat.

It is allowed to use anesthetic spray and solutions for rinsing the throat. If you are not allergic to bee products, use honey. This remedy strengthens the immune system, softens the throat and fights bacteria.

Infectious mononucleosis is often complicated by viral infections - in this case it is carried out antibacterial therapy. Patients need to be provided with plenty of fortified drinks, dry and clean clothes, and attentive care. Due to liver damage not recommended often take antipyretics, such as paracetamol.

In case of severe hypertrophy of the tonsils and the threat of asphyxia, a short-term course of prednisolone is prescribed. During treatment worth giving up from fatty ones, fried foods, hot sauces and seasonings, carbonated drinks, too hot food.

Medications

Important: facilities penicillin group contraindicated.

As a rule, the following medications are prescribed for mononucleosis:

• antipyretics (Ibuprofen, Paracetamol);
• vitamin complexes;
• local antiseptics;
• immunomodulators;
• hepatoprotectors;
• choleretic;
• antiviral;
• antibiotics;
• probiotics.

Treatment of mononucleosis in children

Children with light forms mononucleosis is treated at home, and in severe forms, when the liver and spleen are enlarged, they are hospitalized in an infectious diseases hospital.

In the acute period of the disease, in order to avoid injury to the enlarged spleen (or its ruptures), it is important to observe bed rest . Treatment of mononucleosis in children is combined with herbal medicine. In this case, decoctions are effective.

Take equal parts of chamomile, calendula and immortelle flowers, coltsfoot leaves, yarrow grass and strings. Grind the herbs in a meat grinder. Next, take two tablespoons of the mixture and pour a liter of boiling water. The broth is infused in a thermos overnight. Take the infusion half an hour before meals, 100 ml.

Children are prescribed special diet which must be followed six months to a year. At this time, nothing fatty, smoked, or sweet is allowed. The patient should consume as often as possible:

• dairy products;
• fish;
• lean meat;
• soups (preferably vegetable);
• puree;
• porridge;
• fresh vegetables;
• fruits.

At the same time, you will have to reduce your consumption of butter and vegetable oil, sour cream, cheese, sausages.

• peas;
• beans;
• ice cream;
• garlic.

After recovery, the child is monitored by an infectious disease specialist for 6 months so as not to miss blood complications. The disease leaves behind a strong immunity.

Instructions for the use of drugs for mononucleosis

Recovery from mononucleosis

Recovery after infectious mononucleosis occurs under medical supervision. Consultations with a hepatologist are required, as well as regular biochemical, serological studies and blood tests.

When children hold on elevated temperature, they eat reluctantly, mostly they drink a lot - let it be sweet tea with lemon, non-acidic fruit drinks and compotes, natural juices no preservatives. When the temperature returns to normal, the child's appetite improves. Six months must be observed proper diet so as not to overload the liver.

Child after mononucleosis, gets tired quickly, feels overwhelmed and weak, and needs more time to sleep. You should not overload your child with home and school chores.

To prevent complications mononucleosis children need to follow some recommendations for six months:

The child needs leisurely walks fresh air, staying in the village or in the country has a beneficial effect on recovery after illness.

Complications of mononucleosis

As a rule, mononucleosis ends full recovery.

But sometimes serious complications occur:

• febrile syndrome;
• pneumonia;
• uveitis

Neurological complications

• polyneuropathy;
• encephalitis;
• meningitis;
• mental disorders.

Hematological complications

• decreased platelet count;
• death of red blood cells;
• decrease in the number of white blood cells.

Splenic rupture

A serious complication of mononucleosis, accompanied by a decrease in blood pressure, severe abdominal pain and fainting.

Causes of mononucleosis

The sources of the infectious agent are a person suffering from infectious mononucleosis and a virus carrier. Infection occurs by airborne droplets, through direct contact (for example, with a kiss), through household items contaminated with saliva.

The virus is detected in saliva at the end of the incubation period of the disease, during the peak period and sometimes 6 months after recovery. Isolation of the virus is observed in 10-20% of people who have had infectious mononucleosis in the past.

How can you become infected with mononucleosis?

The source of infection is a sick person or a healthy virus carrier. The disease is not contagious, which means that not everyone in contact with the patient or virus carrier gets sick. You can become infected by kissing, sharing personal hygiene products with a sick person (towels, washcloths, children sharing toys), or by blood transfusion.

Even after past illness the patient continues to release the Epstein-Barr virus into the external environment for a long time (up to 18 months!). This has been proven by numerous studies.

Half of people experience infectious mononucleosis adolescence: boys at 16-18 years old, girls at 14-16 years old, then the incidence rate drops.

Persons over 40 years of age suffer from infectious mononucleosis extremely rarely. This does not apply to patients with AIDS or HIV infected; they suffer from mononucleosis at any age, in severe forms and with severe symptoms.

How to avoid getting mononucleosis

There is no vaccine against infectious mononucleosis. There are no special preventive measures aimed at preventing this particular disease. Doctors' recommendations boil down to the fact that it is necessary to increase immunity and take the same preventive measures as for other viral infections.

To improve immunity, regularly do a set of hardening activities. Wash your face with cool water, walk around the house barefoot, take cold and hot shower, gradually increasing the duration of the cold part of the procedure and reducing the water temperature. If doctors do not prohibit it, douse yourself with cold water in winter.

Try to lead healthy image life, give up bad habits. Include in your diet easily digestible foods with vitamins and microelements: citrus fruits, dairy and other products. Physical education classes, walks in the fresh air, and morning exercises are required.

In consultation with the doctor, take medications that enhance immunity. Better plant origin, for example, tincture of eleutherococcus, ginseng, and Schisandra chinensis.

Since mononucleosis is transmitted by airborne droplets, it is necessary to avoid contact with a sick person. People who interacted with him become ill within twenty days, counting from the day of last contact.

If a child visiting is sick kindergarten , it is required to carry out a thorough wet cleaning of the group premises, using disinfectants. Items sharing(dishes, toys) are also subject to disinfection.

To other children who attended the same group, as prescribed by the pediatrician, specific immunoglobulin is administered to prevent the disease.

Questions and answers on the topic "Mononucleosis"

Hello, a one and a half year old child has elevated monocytes and atypical mononuclear cells in the blood. Enlarged tonsils and lymph nodes. No rash. The liver and spleen are not enlarged. Could this be infectious mononucleosis? Thank you.

The child suffered from mononucleosis a month ago, and his lymph nodes are still enlarged. Temperature is either 37 or 36.8

Daughter is 11 years old. I got sick with mononucleosis a month ago, and the cervical lymph node is going away very slowly, I don’t know how to deal with it. Help me please!

My son is 5 years old. We get sick very often, sometimes more than once a month. A month ago we were discharged from the hospital after suffering from infectious mononucleosis. Today my temperature rose again to 37.3 and my throat turned red. Throughout the month they took Cecloferon and Viferon. What to do for treatment now? Please tell me.

Lymph nodes sometimes remain enlarged (not inflamed) quite long time. If the child feels normal, everything is fine. They will pass with time. Continue to monitor your child's temperature and take your child to the doctor if the temperature rises above 38.5 C.

Tell me, what tests are needed to detect mononucleosis?

Blood analysis.

I’m 29. Three weeks ago, the lymph node in my neck became enlarged and painful. right side, the next day the same thing happened with the left one and my throat became very swollen. After 4 days the sore throat went away and started coughing and the temperature rose to low-grade. After another 3 days the temperature rose to 38, ceftriaxone was prescribed, the temperature rose every day, on the sixth day of the antibiotic it began to drop to normal values, the lymph nodes returned to normal. After 4 days, low-grade fever again, after another 2 days severe swelling throat and enlarged lymph nodes throughout the body. Wherein heavy sweating at night for two weeks and a dry cough. Could this be mononucleosis?

The diagnosis of mononucleosis is made on the basis of laboratory tests.

I am 62 years old. At the end of July I had a sore throat that I still can’t cure. I visited the ENT doctor. I took tests - BARRA virus - 650. The doctor said that she had once had mononucleosis and had very low immunity. Having found your site I read that recurrent disease mononucleosis is impossible, then why can’t I cure my throat. And which doctor should I contact (in this moment I rinse alternately with chamomile, diluted alcohol infusion propolis, tanzelgon and lugol) or is it all about immunity? And what do YOU ​​recommend?

If the ENT specialist has not prescribed treatment and paid attention to immunity, you need to contact an immunologist.

Can there be complications in the joints after having mononucleosis a month ago?

Unlikely.

On the seventh day, the child (daughter, almost 9 years old) had a fever; for the first 4 days it rose to 39.5. For the first 2 days, the child complained that it was painful to look at and had a headache, which usually happens with the flu, nothing else bothered him, they started taking Ingoverine. My throat turned red on the 4th day, but there was no plaque or pain, the doctor examined me and diagnosed ARV. However, in the evening on the 4th day they called an ambulance, the doctor suspected mononucleosis, the child was taking an antibiotic, they took a general blood test, a large number of leukocytes, mononuclear cells were within normal limits (as the pediatrician said), the lymph nodes were enlarged. On day 7 (today) we donated blood to detect early antibodies and the virus itself, the result will be ready in 2 days. The doctor gave a referral for hospitalization and this worries us very much, because in infectious diseases department Of course, I don’t want to be with the child at all. Please tell me how long is hospitalization necessary? My nose is bothering me (difficulty breathing), I don’t have much of a runny nose!

Patients are hospitalized according to clinical indications. The main indications for hospitalization and treatment of a patient in a hospital are: prolonged high fever, jaundice, complications, diagnostic difficulties.

My child is 1.6 months old. We went to the nursery for 4 days and fell ill with mononucleosis. For 7 days the temperature was below 40. We were admitted to the hospital. We injected her with antibiotics for 7 days and continue to take acyclovir. Now he's breaking out in pimples. Is this an allergy or is this how the disease manifests itself? What to do?

At the height of the disease, patients receiving antibiotics often develop an allergic rash. This is most often observed when prescribing penicillin drugs. Tell your doctor about this.

A 3-year-old child suffered from infectious mononucleosis and subsequently suffers from ARVI every month. How does mononucleosis 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, but another reason (decreased immunity), which may have led to the child developing mononucleosis. Infectious mononucleosis does not have a long-term effect on the immune system and does not cause late complications. To prevent ARVI, it is necessary to strengthen the immune system.

Please tell me, a 14-year-old child suffered from mononucleosis. How to determine whether there are complications? Our friends advised us to donate blood for AST and ALT. is this necessary? And is it necessary to test for antibodies to mononuclear cells?

How long has it been since your child had mononucleosis? Was the child examined by a doctor? If the child has no complaints, no yellowing of the sclera of the eyes or skin, then the presence of complications of mononucleosis is practically excluded. You do not need to take any additional tests.

My granddaughter will be 6 years old in December. A diagnosis of mononucleosis was made. There was no high temperature. Now they said that the liver is enlarged by +1.5-2 cm. What should the diet be?

Next: good nutrition, inclusion in the diet boiled meat, low-fat varieties fish, vegetables, fruits, dairy products, cereals. Fried, fatty, spicy foods are excluded.

A 15-year-old boy suspected of infectious mononucleosis has been ill for 5 days: strong pain sore throat, nasal congestion, lack of appetite, severe weakness, headache, the high temperature has lasted for 4 days (38.7-39.1). I knock it down with Nurofen (2 days), take Zinnat (2 days), Tantum Verde, Nazivin, Aqualor, rinse. Before Nurofen I beat it with Panadol (2 days). On palpation the liver is enlarged, white coating on the tonsils (fol. sore throat). Why does the temperature continue to persist? Is it harmful to take Nurofen for more than 3 days? And how long can a high temperature last? Tomorrow we will take a general urine and blood test.

It can last quite a long time (up to several weeks). Taking Nurofen for more than 3 days is not dangerous, but we recommend that you additionally consult your doctor about this.

Six months ago I suffered from infectious mononucleosis. I carried it on my feet because I didn’t know. Then I just got tested for infections and found that I had it. There was a high temperature, the cervical and occipital lymph nodes were enlarged. After that I felt fine. The infectious disease specialist said that I no longer needed her treatment, and why I had a fever - let other doctors find out. Now I have had long-term sovereignty for six months. Malaise. Weakness. In the morning the temperature is 35.8, in the evening it rises. None of the doctors can say anything. And literally 3 days ago I also caught a cold. Regular ODS. But it is impossible to sleep at night, the lymph nodes on the back of the head and in the ears have enlarged. Now I don't know what it is. What does this have to do with!!! Help me please!!

As a rule, infectious mononucleosis does not require specific treatment and always ends in recovery. The disease almost never recurs. After recovery, a person often has a weakened immune system and an increased susceptibility to other infections. There are many reasons for increased body temperature, so diagnosis is only possible through direct contact with a doctor, who will determine the presence of other symptoms and also prescribe additional tests.

Please tell me whether it is possible to vaccinate children (3 and 6 years old) with DPT and polymelitis if they are diagnosed with infectious mononucleosis or cytomegalovirus. We have been treating these infections for 2 years now, but to no avail. There is no acute phase now. Before this, the immunologist gave medical advice only once, when there was an acute phase, but the hematologist gives medical advice all the time. They require either medical clearance or vaccination from kindergarten. I know that it is practically impossible to cure these infections; I only poison the children’s bodies with medications. The last time the youngest was prescribed vitamins (his lymph nodes in his neck are constantly inflamed). A re-examination is now necessary. But I don’t want to go, because I know that the analysis will show the same thing, and the treatment will be the same.

In this case, vaccinations can be done.

How can you quickly and effectively increase a child’s immunity after mononucleosis?

The immune system is too complex and finely structured, and therefore it can be upset by any too sharp and active influences.

My 12-year-old son suffered from a severe form of mononucleosis in June. We are currently taking cycloferon. Recently the child began to complain of strong, rapid heartbeats. IN calm state, without physical activity, the pulse can reach 120 beats per minute with blood pressure within 120/76 - 110/90. Cases of this strong heartbeat happen even at night. Could these symptoms indicate any complication after an illness? Or is it something else? And which doctor should I contact?

You should take your child to a pediatrician and a cardiologist. Despite the fact that heart damage in mononucleosis is practically excluded, consultation with a cardiologist in this case is still necessary.

Is it possible to get infectious mononucleosis again?

Recurrence is practically impossible.

My 12 year old son has mononucleosis. Acute stage the disease has passed. Now we are recovering at home. I was constantly next to him, almost never left. I am 41 years old. Now I felt bad too. The temperature stays at 37.3 - 37.8. Severe weakness. Sore throat, the nose periodically does not breathe. The feeling that this pain and discomfort wants to move into the ears. My eyes were very red. Can I now become a carrier of this virus or get mononucleosis myself?

The symptoms you described are not typical for mononucleosis and it is generally unlikely that you contracted this disease from a child. you may have an episode of a common ARVI, common at this time of year (adenovirosis). We recommend symptomatic treatment of colds with folk remedies. If you notice pain in the liver area, swollen lymph nodes, or any other signs of mononucleosis, be sure to consult a doctor.

My 12 year old son was diagnosed with mononucleosis. The disease is difficult. The temperature reached 40.4. Symptoms of this disease filming traditional means. At this point in time it is the 6th day of illness. The temperature stays between 38.3 - 39.5. I refuse hospitalization due to the fact that the child eats exclusively homemade food. Maintaining this condition in the hospital is not possible, due to the fact that appetite can occur at any time of the day when the temperature drops, even at night. Can I treat this disease while staying at home? What are the possible risks associated with this disease?

In most cases it proceeds favorably, which makes possible treatment at home, but despite this you should keep your child under medical supervision. The most dangerous complication of mononucleosis is splenic rupture, so make sure that for some time after recovery the child refrains from active games that could lead to a fall or abdominal injury.

Infectious mononucleosis is an acute viral disease caused by the Epstein-Barr virus, which is relatively stable during external environment.

This disease is characterized by fever, damage to the lymph nodes, pharynx, spleen, liver, as well as peculiar changes in blood composition.

Infectious mononucleosis is sometimes called the “kissing disease”, which is associated with its airborne transmission, in particular through kissing, when sharing a bed, linen, and dishes. Favorable places for the spread of the virus are places with large crowds of healthy and sick people - kindergartens, camps, boarding schools, dormitories.

As a rule, the clinical picture of infectious mononucleosis develops in young people: the peak incidence in girls is observed at 14-16 years old, and the maximum infection among boys is observed at 16-18 years old. In most people, by the age of 25-35, antibodies to this virus are detected in the blood.

Symptoms of infectious mononucleosis

The duration of the incubation period can vary from 5 to 45 days, but most often lasts 7-10 days. The duration of the disease, as a rule, does not exceed two months. Infectious mononucleosis, symptoms can manifest selectively or complexly, begins with a sharp rise in body temperature, swelling of the cervical lymph nodes, difficulty in nasal breathing and sore throat. These signs of the disease usually develop in full by the end of the first week. On initial stage Most patients also develop symptoms of infectious mononucleosis, such as the presence of peculiar lymphocytes (atypical mononuclear cells) in the blood, as well as an enlargement of the liver and spleen.

The disease can also begin gradually: general malaise, slight fever or its absence, moderate inflammatory processes in the upper respiratory tract. In some patients, body temperature rises significantly only at the height of the disease, but cases where there is no temperature throughout the entire period of infectious mononucleosis are very rare.

An important, very often first symptom of infectious mononucleosis is enlargement of the lymph nodes, especially the cervical ones. They can be seen or felt - the size can vary from the size of a pea to chicken egg. This disease is not characterized by suppuration of the lymph nodes.

Damage to the oropharynx - persistent symptom infectious mononucleosis. Patients experience swelling and enlargement of the palatine tonsils, damage to the nasopharyngeal tonsil, which, in turn, causes difficulty in nasal breathing, severe nasal congestion, constriction of the voice, and “snoring” breathing through the mouth. Infectious mononucleosis is characterized by posterior rhinitis, so nasal discharge is usually not observed during an exacerbation of the disease; it appears only after nasal breathing has been restored. Patients experience swelling of the posterior wall of the pharynx, which is usually covered thick mucus. During the illness, moderate hyperemia of the pharynx and slight sore throat are observed.

Infectious mononucleosis in children in 85% of cases is accompanied by plaque on the nasopharyngeal and palatine tonsils. As a rule, the appearance of this symptom (at the very beginning or on the 3-4th day of illness) causes an even greater increase in temperature and a deterioration in the general condition.

Enlargement of the liver and spleen is observed in 97-98% of patients. Changes in the size of the liver sometimes provoke the appearance of yellowing of the skin, which subsequently disappears along with other manifestations of the disease. Having begun to increase from the first days of the disease and reaching its maximum size on days 4-10, the liver returns to its normal size only by the end of the first - beginning of the second month of the disease.

Often the symptoms of infectious mononucleosis are swelling of the eyelids, puffiness of the face, skin rashes, petechiae and exanthema in the mouth.

The disease can also manifest itself in the form of such disorders from of cardio-vascular system like tachycardia, systolic murmur, muffled heart tones.

Infectious mononucleosis in children is not characterized by a chronic course or relapses. Complications in patients are most often caused by the activation of the microbial flora, as well as the accumulation of acute respiratory viral infections, otitis media, pneumonia, and bronchitis. Pancreatitis, orchitis and mumps are considered rare complications of the disease. In 80% of cases, infectious mononucleosis is completely cured within 2-3 weeks; only in some cases, changes in the blood (the presence of atypical mononuclear cells, moderate leukocytosis) can persist for up to six months. Death illness is possible only in isolated cases - from rupture of the spleen, severe lesions nervous system, with genetic deficiency of the lymphatic system.

Treatment of infectious mononucleosis

At the moment, no specific treatment for infectious mononucleosis has been developed.

The patient is advised to drink plenty of fluids, bed rest, and a diet that excludes fried and fatty foods, spicy seasonings. Symptomatic treatment of infectious mononucleosis includes taking vitamins, using hyposensitizing agents (reduce sensitivity to the allergen), nasal drops, rinsing the throat and throat with iodinol, furatsilin solution, tincture of calendula, sage, chamomile, 3% hydrogen peroxide solution or other antiseptic agents.

In the treatment of infectious mononucleosis, it is advisable to instill interferon into the nose for 2-3 days or use Viferon rectal suppositories for 5-10 days. As an alternative, it is possible to use natural stimulators of interferon production - tinctures of lemongrass, ginseng, lure, arapia, sterculia.

P For infectious mononucleosis, it is recommended to use neovir, which is an antibacterial, antiviral and immunomodulatory agent. Sulfonamide drugs are not prescribed for this disease. Antibiotics can be recommended only if secondary microflora is attached. When treating severe forms of the disease, corticosteroids are used in short courses, in particular prednisolone,

Infectious mononucleosis in children does not require specific treatment. After recovery physical exercise athletes and adolescents should be limited for at least six months in order to reduce the risk of spleen injury.

Prevention of infectious mononucleosis

The sick person must either be isolated at home for 2-3 weeks or hospitalized according to clinical indications. Disinfection is not required, it is enough to ventilate the room and regularly do wet cleaning. The patient should be given separate dishes and necessary care items.

Since a vaccine against infectious mononucleosis has not been developed, active immunization against this disease is not carried out.

Video from YouTube on the topic of the article:

(otherwise called benign lymphoblastosis, Filatov's disease) is an acute viral infection characterized by primary damage to the oropharynx and lymph nodes, spleen and liver. A specific sign of the disease is the appearance of characteristic cells in the blood - atypical mononuclear cells. The causative agent of infectious mononucleosis is the Epstein-Barr virus, which belongs to the herpesvirus family. Its transmission from the patient is carried out by aerosol. Typical symptoms infectious mononucleosis includes general infectious phenomena, tonsillitis, polyadenopathy, hepatosplenomegaly; maculopapular rashes are possible on various areas of the skin.

Complications

Complications of infectious mononucleosis are mainly associated with the development of an associated secondary infection (staphylococcal and streptococcal lesions). Meningoencephalitis, obstruction of the upper respiratory tract by hypertrophied tonsils, may occur. Children may experience severe hepatitis, and sometimes (rarely) interstitial bilateral infiltration of the lungs develops. Also to rare complications include thrombocytopenia, overstretching of the lienal capsule can provoke rupture of the spleen.

Diagnostics

Nonspecific laboratory diagnostics includes a thorough examination of the cellular composition of the blood. A general blood test shows moderate leukocytosis with a predominance of lymphocytes and monocytes and relative neutropenia, a shift in the leukocyte formula to the left. Large cells of various shapes with wide basophilic cytoplasm appear in the blood - atypical mononuclear cells. For the diagnosis of mononucleosis, it is significant to increase the content of these cells in the blood to 10-12%; often their number exceeds 80% of all white blood elements. When examining blood in the first days, mononuclear cells may be absent, which, however, does not exclude the diagnosis. Sometimes these cells can take 2-3 weeks to form. The blood picture usually gradually returns to normal during the period of convalescence, while atypical mononuclear cells often persist.

Specific virological diagnostics are not used due to laboriousness and irrationality, although it is possible to isolate the virus in swabs from the oropharynx and identify its DNA using PCR. There are serological diagnostic methods: antibodies to the VCA antigens of the Epstein-Barr virus are detected. Serum immunoglobulins type M are often detected during the incubation period, and at the height of the disease they are observed in all patients and disappear no earlier than 2-3 days after recovery. The detection of these antibodies serves as a sufficient diagnostic criterion for infectious mononucleosis. After an infection, specific immunoglobulins G are present in the blood and remain for life.

Patients with infectious mononucleosis (or persons suspected of this infection) are subjected to three times (the first time - during the period of acute infection, and with an interval of three months - twice more). serological study to detect HIV infection, since it can also cause the presence of mononuclear cells in the blood. For differential diagnosis tonsillitis with infectious mononucleosis and tonsillitis of other etiologies requires consultation with an otolaryngologist and pharyngoscopy.

Treatment of infectious mononucleosis

Mild and moderate infectious mononucleosis is treated on an outpatient basis; bed rest is recommended in cases of severe intoxication and severe fever. If there are signs of liver dysfunction, diet No. 5 according to Pevzner is prescribed.

There is currently no etiotropic treatment; the complex of indicated measures includes detoxification, desensitization, restorative therapy and symptomatic remedies depending on the available clinic. Severe hypertoxic course, threat of asphyxia when the larynx is compressed by hyperplastic tonsils are an indication for short-term prescription of prednisolone.

Antibiotic therapy is prescribed for necrotizing processes in the pharynx in order to suppress the local bacterial flora and prevent secondary bacterial infections, as well as in case of existing complications (secondary pneumonia, etc.). The drugs of choice are penicillins, ampicillin and oxacillin, and tetracycline antibiotics. Sulfonamide drugs and chloramphenicol are contraindicated due to the side inhibitory effect on the hematopoietic system. Splenic rupture is an indication for emergency splenectomy.

Prognosis and prevention

Uncomplicated infectious mononucleosis has a favorable prognosis; dangerous complications that can significantly aggravate it occur quite rarely in this disease. Residual effects in the blood are the reason for dispensary observation within 6-12 months.

Preventive measures aimed at reducing the incidence of infectious mononucleosis are similar to those for acute respiratory infectious diseases; individual measures are not specific prevention consist of increasing immunity, both with the help of general health measures and with the use of mild immunoregulators and adaptogens in the absence of contraindications. Specific prevention (vaccination) for mononucleosis has not been developed. Measures emergency prevention applied to children who communicated with the patient, consist in prescribing specific immunoglobulin. The area where the disease is occurring is thoroughly cleaned and personal belongings are disinfected.

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Infectious mononucleosis

What is Infectious Mononucleosis -

Infectious mononucleosis(mononucleosis infectiosa, Filatov's disease, monocytic tonsillitis, benign lymphoblastosis) is an acute anthroponotic viral infectious disease with fever, damage to the oropharynx, lymph nodes, liver and spleen and specific changes in the hemogram.

Clinical manifestations of the disease were first described by N.F. Filatov (“Filatov’s disease”, 1885) and E. Pfeiffer (1889). Changes in the hemogram have been studied by many researchers (Bernet J., 1909; Tidy G. et al., 1923; Schwartz E., 1929, etc.). In accordance with these characteristic changes American scientists T. Sprunt and F. Evans called the disease infectious mononucleosis. The pathogen was first isolated by the English pathologist M.A. Epstein and Canadian virologist I. Barr from Burkitt's lymphoma cells (1964). The virus was later named Epstein-Barr virus.

What provokes / Causes of Infectious mononucleosis:

The causative agent of infectious mononucleosis- DNA genomic virus of the Lymphocryptovirus genus of the Gammaherpesvirinae subfamily of the Herpesviridae family. The virus is able to replicate, including in B lymphocytes; unlike other herpes viruses, it does not cause cell death, but, on the contrary, activates their proliferation. Virions include specific antigens: capsid (VCA), nuclear (EBNA), early (EA) and membrane (MA) antigens. Each of them is formed in a certain sequence and induces the synthesis of appropriate antibodies. In the blood of patients with infectious mononucleosis, antibodies to the capsid antigen first appear, and later antibodies to EA and MA are produced. The pathogen is not stable in the external environment and quickly dies when it dries out, under the influence of high temperature and disinfectants.

Infectious mononucleosis is only one form of infection with the Epstein-Barr virus, which also causes Burkitt's lymphoma and nasopharyngeal carcinoma. Its role in the pathogenesis of a number of other pathological conditions insufficiently studied.

The reservoir and source of infection is a person with a manifest or erased form of the disease, as well as a carrier of the pathogen. Infected individuals shed the virus from the last days of incubation and for 6-18 months after the initial infection. In swabs from the oropharynx in 15-25% of seropositive healthy people the virus is also detected. The epidemic process is supported by people who have previously had an infection and secrete the pathogen in their saliva for a long time.

Transmission mechanism- aerosol, transmission route - airborne droplets. Very often, the virus is released in saliva, so infection is possible through contact (kissing, sexual intercourse, through hands, toys and household items). Infection can be transmitted through blood transfusions, as well as during childbirth.

Natural sensitivity of people high, however, light and erased forms diseases. The presence of innate passive immunity can be evidenced by the extremely low morbidity rate in children in the first year of life. Immunodeficiency conditions contribute to the generalization of infection.

Basic epidemiological signs. The disease is widespread; Mostly sporadic cases are recorded, sometimes small outbreaks. The polymorphism of the clinical picture and the rather frequent difficulties in diagnosing the disease give reason to believe that the level of officially registered morbidity in Ukraine does not reflect the true extent of the spread of the infection. Teenagers most often get sick; in girls, the maximum incidence is recorded at 14-16 years old, in boys - at 16-18 years old. Therefore, infectious mononucleosis is sometimes also called “students’ disease.” People over 40 years of age rarely get sick, but in HIV-infected people, reactivation of a latent infection is possible at any age. When infected in early childhood primary infection proceeds in the form respiratory disease, at older ages - asymptomatic. By the age of 30-35, most people have antibodies to the infectious mononucleosis virus in their blood, so clinically pronounced forms are rarely found among adults. Diseases are recorded throughout the year, somewhat less frequently in the summer months. Infection is facilitated by overcrowding, sharing of shared linen, utensils, and close household contacts.

Pathogenesis (what happens?) during Infectious mononucleosis:

Penetration of the virus into the upper respiratory tract leads to damage to the epithelium and lymphoid tissue of the oropharynx and nasopharynx. Swelling of the mucous membrane, enlargement of the tonsils and regional lymph nodes are noted. With subsequent viremia, the pathogen invades B lymphocytes; being in their cytoplasm, it disseminates throughout the body. The spread of the virus leads to systemic hyperplasia of lymphoid and reticular tissues, and therefore in peripheral blood atypical mononuclear cells appear. Lymphadenopathy, swelling of the mucous membrane of the nasal concha and oropharynx develop, the liver and spleen enlarge. Histologically, hyperplasia of lymphoreticular tissue is revealed in all organs, lymphocytic periportal infiltration of the liver with minor dystrophic changes hepatocytes.

Virus replication in B lymphocytes stimulates their active proliferation and differentiation into plasmacytes. The latter secrete immunoglobulins of low specificity. Simultaneously in acute period diseases, the number and activity of T-lymphocytes increase. Suppressor T cells inhibit the proliferation and differentiation of B lymphocytes. Cytotoxic T lymphocytes destroy infected with virus cells recognizing membrane virus-induced antigens. However, the virus remains in the body and persists in it throughout subsequent life, causing chronic course diseases with reactivation of infection with decreased immunity.

Expressiveness immunological reactions in infectious mononucleosis allows us to consider it a disease of the immune system, therefore it is classified as a group of diseases of the AIDS-associated complex.

Symptoms of Infectious Mononucleosis:

Incubation period varies from 5 days to 1.5 months. A prodromal period without specific symptoms is possible. In these cases, the disease develops gradually: subfebrile body temperature, malaise, weakness, increased fatigue, catarrhal phenomena in the upper respiratory tract - nasal congestion, hyperemia of the mucous membrane of the oropharynx, enlargement and hyperemia of the tonsils.

At the acute onset of the disease body temperature quickly rises to high levels. Patients complain of headache, sore throat when swallowing, chills, increased sweating, and body aches. In the future, the temperature curve may be different; The duration of fever varies from several days to 1 month or more.

By the end of the first week of the disease, the peak period of the disease develops. The appearance of all the main clinical syndromes is characteristic: general toxic phenomena, tonsillitis, lymphadenopathy, hepatolienal syndrome. The patient’s health is deteriorating, it is noted high temperature body, chills, headache and body aches. Nasal congestion with difficulty in nasal breathing and a nasal voice may appear. Lesions of the pharynx are manifested by an increase in sore throat, development of sore throat in catarrhal, ulcerative-necrotic, follicular or membranous form. Hyperemia of the mucous membrane is not clearly expressed, loose yellowish plaques that can be easily removed appear on the tonsils. In some cases, plaques may resemble diphtheria. Hemorrhagic elements may appear on the mucous membrane of the soft palate, back wall The pharynx is sharply hyperemic, loose, granular, with hyperplastic follicles.

From the very first days it develops lymphadenopathy. Enlarged lymph nodes can be found in all areas accessible to palpation; Their lesions are characterized by symmetry. Most often with mononucleosis, the occipital, submandibular and especially posterior cervical lymph nodes on both sides along the sternocleidomastoid muscles are enlarged. Lymph nodes are compacted, mobile, painless or slightly painful on palpation. Their sizes vary from pea to walnut. Subcutaneous tissue around the lymph nodes in some cases there may be swelling.

In most patients, during the height of the disease, an enlargement of the liver and spleen is noted. In some cases, icteric syndrome develops: dyspeptic symptoms intensify (decreased appetite, nausea), urine darkens, icterus appears in the sclera and skin, bilirubin content in the blood serum increases and aminotransferase activity increases.

Sometimes an exanthema of a maculopapular nature appears. It has no specific localization, is not accompanied by itching and quickly disappears without treatment, leaving no changes on the skin.

Following the period of the height of the disease, which lasts an average of 2-3 weeks, comes convalescence period. The patient’s well-being improves, body temperature normalizes, and sore throat and hepatolienal syndrome gradually disappear. Subsequently, the size of the lymph nodes is normalized. The duration of the convalescence period varies from person to person; sometimes low-grade body temperature and lymphadenopathy persist for several weeks.

The disease can take a long time, with alternating periods of exacerbations and remissions, which is why its total duration can last up to 1.5 years.

Clinical manifestations of infectious mononucleosis in adult patients differ in a number of features. The disease often begins with the gradual development of prodromal phenomena, fever often persists for more than 2 weeks, the severity of lymphadenopathy and tonsil hyperplasia is less than in children. At the same time, in adults, manifestations of the disease associated with involvement of the liver in the process and the development of icteric syndrome are more often observed.

Complications of infectious mononucleosis
The most common complication is the addition of bacterial infections caused by Staphylococcus aureus, streptococci, etc. Meningoencephalitis, obstruction are also possible upper sections respiratory tract with enlarged tonsils. IN in rare cases bilateral interstitial infiltration of the lungs with severe hypoxia, severe hepatitis (in children), thrombocytopenia, and splenic ruptures are noted. In most cases, the prognosis of the disease is favorable.

Diagnosis of Infectious Mononucleosis:

Infectious mononucleosis should be distinguished from lymphogranulomatosis and lymphocytic leukemia, tonsillitis of coccal and other etiologies, oropharyngeal diphtheria, as well as viral hepatitis, pseudotuberculosis, rubella, toxoplasmosis, chlamydial pneumonia and ornithosis, some forms of adenovirus infection, CMV infection, primary manifestations of HIV infection. Infectious mononucleosis is distinguished by a combination of the main five clinical syndromes: general toxic phenomena, bilateral tonsillitis, polyadenopathy (especially with damage to the lymph nodes along the sternocleidomastoid muscles on both sides), hepatolienal syndrome, and specific changes in the hemogram. In some cases, jaundice and (or) maculopapular exanthema are possible.

Laboratory diagnosis of infectious mononucleosis
Most characteristic feature- changes in the cellular composition of the blood. The hemogram reveals moderate leukocytosis, relative neutropenia with a shift in the leukocyte formula to the left, a significant increase in the number of lymphocytes and monocytes (over 60% in total). Atypical mononuclear cells are present in the blood - cells with wide basophilic cytoplasm, having different shape. Their presence in the blood determined modern name diseases. An increase in the number of atypical mononuclear cells with wide cytoplasm to at least 10-12% is of diagnostic significance, although the number of these cells can reach 80-90%. It should be noted that the absence of atypical mononuclear cells with characteristic clinical manifestations diseases do not contradict the expected diagnosis, since their appearance in the peripheral blood may be delayed until the end of the 2-3rd week of the disease.

During the period of convalescence, the number of neutrophils, lymphocytes and monocytes gradually normalizes, but quite often atypical mononuclear cells persist for a long time.

Virological diagnostic methods (isolation of the virus from the oropharynx) are not used in practice. PCR method viral DNA can be detected in whole blood and serum.

Serological methods have been developed for the determination of antibodies of various classes to capsid (VCA) antigens. Serum IgM to VCA antigens can be detected already in incubation period; subsequently they are detected in all patients (this serves as reliable confirmation of the diagnosis). IgM to VCA antigens disappear only 2-3 months after recovery. After an illness, IgG to VCA antigens remain for life.

In the absence of the ability to detect anti-VCA-IgM, serological methods for detecting heterophilic antibodies are still used. They are formed as a result of polyclonal activation of B lymphocytes. The most popular are the Paul-Bunnell reaction with sheep erythrocytes (diagnostic titer 1:32) and the more sensitive Hoff-Bauer reaction with horse erythrocytes. Insufficient specificity of reactions reduces their diagnostic value.

All patients with infectious mononucleosis or if it is suspected should be tested 3 times (in the acute period, then after 3 and 6 months) laboratory examination for antibodies to HIV antigens, since mononucleosis-like syndrome is also possible during the stage of primary manifestations of HIV infection.

Treatment of Infectious Mononucleosis:

Patients with mild and moderate forms of infectious mononucleosis can be treated at home. The need for bed rest is determined by the severity of intoxication. In cases of illness with manifestations of hepatitis, a diet is recommended (table No. 5).

Specific therapy has not been developed. Detoxification therapy, desensitizing, symptomatic and restorative treatment, rinsing the oropharynx with antiseptic solutions are carried out. Antibiotics are not prescribed in the absence of bacterial complications. In case of hypertoxic course of the disease, as well as in case of threat of asphyxia caused by swelling of the pharynx and pronounced enlargement of the tonsils, a short course of treatment with glucocorticoids is prescribed (prednisolone orally in daily dose 1-1.5 mg/kg for 3-4 days).

Prevention of Infectious Mononucleosis:

Are common preventive measures similar to those for ARVI. Specific prevention measures have not been developed. Nonspecific prophylaxis carried out by increasing the general and immunological resistance of the body.

Which doctors should you contact if you have Infectious Mononucleosis:

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Mononucleosis is an acute infection that affects the body's lymphatic system. The disease occurs with acute fever, sometimes enlarging the spleen and liver. It leads to sore throat and decreased immunity. It is now known for sure that the virus Epstein Barr Infectious mononucleosis almost always causes. Doctors classify it as a herpes infection. The source of the spread of the disease is a sick person, and infection occurs through direct contact, through contaminated household items or by airborne droplets.

Causes of mononucleosis

The mechanisms of transmission of mononucleosis are simple: through saliva, mucus, tears. The disease is also transmitted through kissing, which is why the infection is nicknamed “kissing disease.” The virus, once settled in the body, remains there forever, and even if it is not active, it is easily transmitted to other people. The main causes of mononucleosis in humans are:

• weak immunity;
• severe mental or physical stress;
• suffered stress;
• failure to comply with hygiene rules;
• use of shared linen, dishes, and towels.

Symptoms and signs of the disease

Mononucleosis infection in a patient is characterized by the following symptoms diseases:

1. Fever. The temperature rises, which means the development of microbial activity or their poisons in the human body. Chills occur increased sweating.
2. Angina. There is a pain in the throat when swallowing, inflammatory process on mucous membranes and enlarged tonsils.
3. Damage to the lymph nodes. Lymph nodes and the tissue around them enlarge, usually under the jaw, which indicates the spread of the source of infection.
4. Damage to the spleen and liver. This provokes the appearance in the abdominal area pain varying degrees. By the 10th day of illness, jaundice may be observed. skin.
5. Skin rash. Disappears after fading acute symptoms mononucleosis.
6. Change in blood picture. It is diagnosed by a doctor after taking tests by the presence of mononuclear cells in the blood, as well as an increase in lymphocytes and monocytes.
7. Pathology of the muscles of the heart and pancreas. Occurs in severe forms of infectious mononucleosis in children with reduced immunity.

Methods for treating mononucleosis disease

Viral mononucleosis is a self-limiting infection, so even without treatment, the disease can gradually go away on its own. But in order for the infection to pass faster without developing into chronic form, and the risk of complications was minimal, sick people are recommended to undergo specific treatment as prescribed by a doctor. Mononucleosis is easily treated at home, with bed rest and diet prescribed, but special therapy Doctors have not yet developed a cure for this disease.

Drug treatment

1. "Acyclovir". Since mononucleosis is a viral infection, doctors recommend taking antiviral drugs, reducing the secretion of the Epstein-Barr virus. Acyclovir is prescribed to adult patients 200 mg 5 times a day. The period of treatment of the disease with the drug is 5 days. The dose for children under 2 years of age is half the adult dose, but requires constant medical supervision. During pregnancy, the use of the drug is possible only in exceptional cases.
2. "Viferon". Refers not only to antiviral, but also to immunomodulatory drugs. The medicine increases immunity, helping the body fight the disease. Viferon ointment or gel is prescribed for the first or recurrent infections of the mucous membranes for external use. It has an effect on the mucous membrane of the lesion to which it is applied thin layer 3 times/day for one week.
3. "Paracetamol". Removes pain syndromes with mononucleosis of various origins (fever, headache). Directions for use: 1-2 tablets 4 times/day for 3-4 days.
4. "Faryngosept". An anesthetic drug that helps relieve the symptoms of atypical sore throat. Prescribe 4 tablets/day, which should be dissolved until dissolved. The course of treatment lasts 3-4 days.

Folk remedies against the virus

Symptoms of viral mononucleosis are relieved by the following: folk recipes:

1. Cabbage decoction. The presence of large amounts of vitamin C allows you to quickly relieve the symptoms of fever. To do this, wash the cabbage leaves, cover them with water and cook over low heat for 5 minutes. Then let the broth sit until it cools, and take 100 ml every hour until your body temperature drops.
2. To reduce sore throat, you need to gargle it with a decoction of chamomile and rose hips. To prepare it, take 150 g of dried chamomile flowers, 1 tbsp. l. pharmaceutical rose hips, brew in a thermos, let it brew for 2 hours. Then gargle every 1-1.5 hours until it is completely restored.
3. To reduce intoxication of the body and increase immunity during a viral disease, you need to prepare a decoction of calendula flowers, chamomile sage. To do this, take fresh or dry herbs in equal proportions, pour boiling water over them and place on water bath for 15 minutes. After the broth has cooled, drink 150 ml 3 times a day until complete recovery.

Possible complications and consequences

The disease is dangerous due to its complications. The virus has oncogenic activity, which is why after mononucleosis you should not be in the sun for 3-4 months. Although mononucleosis infection very rarely ends in death, it is possible that after the disease the development of inflammation of the brain, bilateral lung damage with severe oxygen starvation. Rarely, but with severe disease, splenic rupture is possible. In immunocompromised children, infectious mononucleosis can lead to hepatitis, the main symptom of which is jaundice.

Forecast and prevention of the disease

In 90% of cases of detection of the infectious disease mononucleosis, the prognosis is favorable. However, after an infection, the body remains weak. A decrease in immunity due to illness can last up to 6 months, so it is indicated general strengthening body: regular rinsing throat and nose with herbal decoctions, hardening, taking vitamin complexes, proper nutrition, frequent exposure to fresh air.

Which doctor should I contact to diagnose the disease?

An infectious disease specialist treats mononucleosis. This specialist is easy to find in any infectious diseases hospital of a city or regional scale. The doctor is responsible for the diagnosis and treatment of mononucleosis and other viral diseases. He studies the causes of the disease and the mechanism of development of infection in each individual case, determining clinical picture using bacterial cultures, blood and urine tests, biochemical research, Ultrasound, X-ray, electrocardiography, irrigoscopy.

Video: how mononucleosis is transmitted and how to cure it

Childhood mononucleosis most often develops after the age of 10 years, and infants under 1 year of age practically do not suffer from this infectious disease. This is due to the fact that children at this age do not communicate with peers and with a large number of adults who are contagious. Into the child's body viral disease enters, as a rule, through the mucous membrane of the upper respiratory tract, where its journey through the body begins. Let's watch the opinion of a famous person in the video pediatrician Dr. Komarovsky on how best to treat infectious mononucleosis: