For a whole year the temperature does not subside and the symptoms do not disappear after infectious mononucleosis. Change in body temperature in mononucleosis

Infectious mononucleosis is a viral infectious disease that affects the liver, spleen, and lymphoid tissue. Children between 3 and 10 years old are most prone to this type of infection, but adults can also get sick.

Infectious mononucleosis in most cases is mild, and its symptoms resemble a sore throat or a cold, so it is not always possible to make a timely diagnosis. But the most difficult in terms of diagnosis is atypical mononucleosis in children, since its symptoms can be masked as other diseases.

The danger of infectious mononucleosis lies in its complications, which, if not detected in time, can lead to death.

To help you protect your child from this disease, we propose to consider in more detail its first signs, symptoms, treatment and effective methods of prevention. We will also show informative photos and videos on this topic.

Epstein-Barr virus type 4 belongs to the herpesvirus family and is the causative agent of infectious mononucleosis.

This virus contains genetic material, which is represented by double-stranded DNA. The reproduction of the virus occurs in human B-lymphocytes.

The pathogen antigens are represented by capsid, nuclear, early and membrane types. In the early stages of the disease, capsid antigens can be detected in the blood of a child, since other antigens appear during the height of the infectious process.

Epstein-Barr virus is affected by direct sunlight, heat, and disinfectants.

How is mononucleosis transmitted?

The source of infection in mononucleosis is a patient with a typical or atypical form, as well as an asymptomatic carrier of the Epstein-Barr type 4 virus.

For infectious mononucleosis, a characteristic airborne route of spread, that is, it expands its presence when sneezing, coughing, kissing.

Also, the virus can be transmitted by household and hematogenous routes.

Since the causative agent of infectious mononucleosis is transmitted mainly through saliva, this disease is often called "kissing disease".

Children who live in hostels, boarding schools, orphanages, as well as those who go to kindergarten get sick more often.

What is the mechanism of development of infectious mononucleosis?

The infection enters the human body through the mucous membrane of the upper respiratory tract (mouth, nose and throat), which leads to swelling of the tonsils and local lymph nodes. After that, the pathogen spreads throughout the body.

Infectious mononucleosis is characterized by hyperplasia of the lymphoid and connective tissues, as well as the appearance in the blood of atypical mononuclear cells, which are a specific marker of this disease. In addition, there is an increase in the liver, spleen and lymph nodes.

It is possible to cure infectious mononucleosis, but even after recovery, the virus remains in the child’s body and, under adverse conditions, can begin to multiply again, which is fraught with a relapse of the disease.

Infectious mononucleosis can be acute or chronic. It is also customary to distinguish between typical and atypical forms of the disease. Typical mononucleosis, in turn, is divided by severity: mild, moderate and severe.

Atypical mononucleosis can occur with blurred symptoms, asymptomatically, or only with signs of damage to internal organs.

If we classify the disease depending on the presence of complications, then infectious mononucleosis can be uncomplicated and complicated.

How long is the incubation period for infectious mononucleosis?

The incubation period is the initial stage of infectious mononucleosis, which generally takes from 1 to 4 weeks in the acute course and from 1 to 2 months in the chronic course of the disease. This stage is necessary for the reproduction of the virus, which occurs in B-lymphocytes.

It is impossible to say exactly how long this stage of the disease will last in a particular child, since the duration directly depends on the state of the patient's immunity.

How does infectious mononucleosis manifest itself in children?

The clinical manifestations of infectious mononucleosis depend on its course, so we will consider each form of the disease separately.

In children, symptoms of acute mononucleosis appear abruptly. The incubation period of the disease ends with a rise in body temperature to high numbers (38-39 ° C).

With mononucleosis in children, there are the following symptoms:

lymphadenopathy, primarily of the cervical behind-the-ear lymph nodes;
pain in the area of enlarged lymph nodes;
swelling of the mucous membrane of the throat, which is expressed by difficulty breathing;
throat hyperemia;
sore throat;
nasal congestion;
general weakness;
chills;
loss of appetite;
pain in muscles and joints;
white plaque on the mucous membranes of the tongue, palate, tonsils and posterior pharyngeal wall;
splenomegaly (enlargement of the spleen);
hepatomegaly (enlargement of the liver);
small, red, and thick rash on the face, neck, chest, or back;
swelling of the eyelids;
photophobia and others.

Answering the question of how dangerous the patient is to others in this case, we can say that the release of the virus into the external environment occurs during the incubation period and in the first 5 days of the peak of the disease. That is, a child is contagious even when he does not yet show symptoms of infectious mononucleosis.

Experts have not yet been able to reliably determine the cause of chronic mononucleosis.

But there are a number of factors that contribute to this:

immunodeficiency;
unhealthy diet;
harmful;
sedentary lifestyle;
frequent psycho-emotional shocks;
hormonal changes during puberty;
mental and physical overwork and others.

Chronic mononucleosis in children is characterized by symptoms of an acute course of the disease, only their severity is less intense.

Fever in the chronic course of infection is rare, and the spleen and liver, if hypertrophied, are insignificant.

In children, there is a deterioration in the general condition, which is expressed by general weakness, drowsiness, fatigue, decreased activity, etc. There may also be a violation of the stool in the form of constipation or diarrhea, nausea, and rarely vomiting.

Why is mononucleosis dangerous?

In general, the course of infectious mononucleosis is mild and uncomplicated. But in rare cases there may be the following complications:

bronchial obstruction;
myocarditis;
inflammation of the meninges and brain tissues;
accession of bacterial flora (bacterial tonsillitis, pneumonia and others);
hepatitis;
immunodeficiency and others.

But the most dangerous complication of infectious mononucleosis is the rupture of the spleen capsule, which is characterized by the following symptoms:

nausea;
vomit;
dizziness;
loss of consciousness;
severe general weakness;
severe pain in the abdomen.

Treatment of this complication consists in emergency hospitalization and surgical intervention - removal of the spleen.

Algorithm for the diagnosis of infectious mononucleosis in children consists of several steps.

Subjective diagnostic methods:

questioning the patient;
collecting an anamnesis of the disease and life.

Objective methods of examination of the patient:

examination of the patient;
palpation of the lymph nodes and abdomen;
abdominal percussion.

Additional diagnostic methods:

laboratory diagnostics (general blood test, biochemical blood test, blood test to determine antibodies to the Epstein-Barr virus);
instrumental diagnostics (ultrasound examination of the abdominal organs, including the liver and spleen).

When questioning the patient, they pay attention to the symptoms of intoxication, pain in the throat and behind the jaw, and also clarify whether there was any contact with children with infectious mononucleosis.

When examining patients with mononucleosis, there is often an increase in the behind-the-ear lymph nodes, and in young children, an enlarged liver or even spleen is clearly visible. When examining the throat, its granularity, redness and swollen mucosa are determined.

On palpation, enlarged and painful lymph nodes, liver and spleen are determined.

In the patient's blood, indicators such as slight leukocytosis, an increase in the erythrocyte sedimentation rate, and the presence of wide plasma lymphocytes can be detected.

A specific sign of infectious mononucleosis is the appearance in the blood of atypical mononuclear cells - giant cells with a large nucleus, which consists of many nucleoli. Atypical mononuclear cells can stay in the blood of a recovered child for up to four months, and sometimes longer.

But the most informative blood test for mononucleosis is the detection of antibodies to the pathogen or the determination of the genetic material of the virus itself. For this, enzyme immunoassay (ELISA) and polymerase chain reaction (PCR) are carried out.

Why is it necessary to conduct and decipher ELISA and PCR? Deciphering the listed blood tests is necessary to identify the virus and confirm the diagnosis.

Diagnosis and treatment of infectious mononucleosis is carried out by an infectious disease specialist. But patients can also be referred for consultation to related specialists, for example, an otolaryngologist, an immunologist, and others.

If the diagnosis is unclear, the attending physician considers testing for HIV, since this disease can cause the growth of atypical mononuclear cells in the blood.

Ultrasound examination of the abdominal organs allows you to determine the degree of hepato- and splenomegaly.

Komarovsky devoted an article to infectious mononucleosis in children in his book, where he describes in detail the symptoms and treatment of this disease.

A well-known TV doctor, like most specialists, claims that a specific treatment for mononucleosis has not yet been developed and, in principle, it is not necessary, since the body is able to cope with the infection on its own. In this case, adequate prevention of complications, symptomatic treatment, limitation of stress and nutrition play an important role.

It is possible to treat infectious mononucleosis in children at home under the guidance of a pediatrician and an infectious disease specialist. In severe cases, the patient is hospitalized in the infectious diseases department or hospital.

Indications for inpatient treatment is:

temperature above 39.5°C;
severe edema of the upper respiratory tract;
severe intoxication;
occurrence of complications.

In the treatment of infectious mononucleosis, Komarovsky recommends adhering to the following principles:

bed rest;
diet;
antipyretic therapy at a body temperature above 38.5 degrees, and also if the child does not tolerate fever. In such cases, Nurofen, Efferalgan, Ibuprofen and others are prescribed;
with a pronounced inflammatory process in the throat, local antiseptics are used - Septefril, Lysobact, Orosept, Lugol, as well as local immunotherapy drugs, such as Immudon, IRS-19 and others;
vitamin therapy with complex vitamin preparations, which necessarily contain B vitamins, as well as ascorbic acid;
in violation of the liver, choleretic agents and hepatoprotectors are used;
immunotherapy, which consists in the appointment of interferons or their inducers, namely: Viferon, Cycloferon, Imudon, human interferon, Anaferon and others;
antiviral therapy: Acyclovir, Vidabarin, Foscarnet and others. Acyclovir in mononucleosis is prescribed at a dose of 5 mg / kg of body weight every 8 hours, Vidabarin - 8-15 mg / kg / day, Foscarnet - 60 mg / kg every 8 hours;
antibiotics for mononucleosis to a child can be prescribed only when a secondary bacterial flora is attached (streptococcal tonsillitis, pneumonia, meningitis, etc.). It is forbidden to use penicillin antibiotics for mononucleosis, since they cause allergies in many children. Also, the child must be prescribed probiotics, such as Linex, Bifi-form, Acipol, Bifidumbacterin and others;
hormone therapy is indicated for children with severe intoxication. For this, prednisolone is used.

The period of convalescence in infectious mononucleosis takes from two weeks to several months, its duration depends on the severity of the disease and whether there were consequences.

The patient's condition improves literally a week after the normalization of body temperature.

During treatment and 1.5 months after recovery, the child is freed from any physical activity in order to prevent the development of such consequences as rupture of the spleen capsule.

If the temperature is maintained during mononucleosis, then this may indicate the addition of a secondary bacterial flora, since during the recovery period it should not exceed 37.0 ° C.

You can visit the kindergarten after mononucleosis when the indicators in the blood normalize, that is, atypical mononuclear cells disappear.

Both during the treatment of infectious mononucleosis and after recovery, patients should follow a diet, especially if the liver has been affected.

Nutrition should be balanced and easily digestible so as not to overload the liver. With hepatomegaly, table No. 5 according to Pevzner is prescribed, which involves limiting animal fats, excluding hot spices, spices, marinades, sweets and chocolate.

The patient's menu should consist of liquid soups, semi-liquid cereals, lean meats, poultry and fish. When cooking, it is recommended to use gentle heat treatment methods, such as boiling, baking or steaming.

A diet after infectious mononucleosis should be followed for 3 to 6 months, depending on the severity of the disease. After this period, the menu can be expanded and diversified.

Medicinal herbs such as chamomile, milk thistle, corn stigmas, lemongrass and others, which are consumed in the form of tea, help restore liver cells.

It is also important for infectious mononucleosis to observe an adequate drinking regime according to age.

What are the methods of preventing infectious mononucleosis in children?

Specific prevention of infectious mononucleosis has not been developed. You can prevent the development of the disease by strengthening the immune system using the following methods:

active and ;
observance by the child of a rational regimen of the day;
exclusion of mental and physical overload;
dosed sports loads;
sufficient time spent outdoors;
healthy and balanced diet.

Despite the fact that infectious mononucleosis does not die, do not take it lightly. The disease itself is not fatal, but can cause life-threatening consequences - meningitis, pneumonia, bronchial obstruction, ruptured spleen, etc.

Therefore, at the first signs of infectious mononucleosis in your child, we strongly recommend that you contact a pediatrician at the nearest clinic or immediately an infectious disease specialist and in no case self-medicate.

One of the diseases that is rapidly spreading in children's groups is mononucleosis. Adults also suffer from it. In most cases, the Epstein-Barr virus becomes the causative agent of the infectious process, less often - cytomegalovirus.

The disease can proceed without a significant deterioration in the condition. But the temperature with mononucleosis rises almost always. How high the thermometer shows and how long the fever persists depends on the severity of the disease.

Mononucleosis is a viral disease. Its most common cause is infection with the Epstein-Barr virus, less often with cytomegalovirus. Both of them belong to the herpes family. In addition to those named, in rare cases, other representatives of the kingdom of viruses can provoke an infectious process:

poorly studied herpes 6 and 7 types;
adenovirus;
immunodeficiency virus.

The Epstein-Barr virus is easily transmitted by airborne droplets. Most often, children who attend kindergartens or schools become infected. Adults are at risk of becoming infected through kissing, sexual contact, as well as during the transfusion of blood or its components, transplantation of donor organs.

The human body is very susceptible to the virus. Almost everyone who is infected develops mononucleosis. But in less than half of the patients, the infectious process is accompanied by characteristic symptoms. Often people do not even realize that they have been ill.

Why does the temperature rise with mononucleosis

The infection is transmitted with saliva, other secretions of a sick person. Having fixed on the surface of the mucous membrane of the mouth, nose or other organs, the virus penetrates into epithelial cells. From there, the infection travels to the salivary glands.

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

Human immunity reacts to the accumulation of infectious units by the synthesis of a large number of T-killers. These immune cells destroy other body cells already affected by the virus. As a result, when cells break down, a lot of biologically active substances enter the bloodstream. Their circulation and effect on the temperature center in the brain (hypothalamus) causes an increase in temperature in mononucleosis.

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

What is the temperature with mononucleosis

Following the incubation stage, the prodromal stage of the disease begins (the period of primary manifestations of the disease). At this time, the sick person begins to feel weakness, irritability, muscle pain. This state lasts 7-14 days. After the disease goes to the peak stage.

A feverish state during viral infection can persist from several days to a month. During the course of the disease, the thermometer readings are not the same, they often fluctuate.

Often, the onset of mononucleosis is accompanied by a temperature of 37 degrees, then it rises to 38-38.5. The mercury column of the thermometer can reach even higher numbers - from 39 to 40 degrees.

Despite the fever, most patients with mononucleosis maintain a satisfactory state of health. A person remains active, but appetite falls, fatigue appears unusual before. Muscle weakness may occur.

In children of kindergarten age, younger students are often diagnosed with angina-like manifestations. Tonsils in the sky are covered with a whitish coating, strongly swell. Adenoid tissue is also affected by the virus. Therefore, breathing through the nose also causes difficulties. Similar symptoms of mononucleosis are accompanied by high fever.

Active reproduction of the virus leads to polyadenopathy - damage to the glands. Not only the glandular tissue of the nasopharynx suffers. The size of the lymph nodes on the neck, the back of the head, on the bends of the elbows, in the intestines increase. The liver and spleen are vulnerable to the virus. These organs significantly increase their size, become painful when pressed. With this form of the infectious process caused by the Epstein-Barr virus, the temperature is kept at 37 degrees.

Swollen lymph nodes in mononucleosis

How long does the temperature last with mononucleosis

The duration of temperature in mononucleosis depends on the severity of the course of the disease. Occurring in parallel with symptoms resembling a cold, the fever persists on average up to 5 days.

The thermometer shows high numbers in the evening hours. Decrease in indicators is observed in the morning.

In severe cases of the disease, temperature indicators reach 40 degrees. The fever persists for 10 or more days, sometimes lasting up to a month.

When the peak of the infectious process has passed, the thermometer readings return to normal. The patient becomes more active, his lymph nodes decrease in size. Gradually returns appetite. Despite normal health, the recovery period after a viral infection lasts quite a long time. It will take 6 months to a year to fully recover. Up to 3 months, there may be an increase in temperature to subfebrile figures (37-37.9 degrees).

Features of the temperature reaction in a child

Preschool children and younger schoolchildren are more likely to get mononucleosis in the autumn months. During this period, due to the onset of cold weather, babies often catch colds, which leads to a decrease in immune defenses.

The children's body usually reacts violently to the Epstein-Barr virus. In parallel with swelling of the lymph nodes and palatine tonsils, nasal congestion, the temperature rises sharply with mononucleosis in children up to 37.8-38.5 degrees.

With a mild course of the infectious process, subfebrile indicators on the thermometer persist from 1 to 5 days. A moderate condition in a baby is accompanied by a weekly fever of up to 38.5 degrees. A severe form of the disease is associated with a fever above 39 degrees for up to 14 days.

When does mononucleosis develop without fever?

Quite often, in adults or children, doctors diagnose infectious mononucleosis without fever. A similar phenomenon indicates insufficient resistance of the body to the virus. The weakening of the immune system is caused by various factors, including:

ARI in children more than four times, in adults - more than three times a year;
protracted course of acute viral diseases with the addition of complications;
chronic inflammatory processes in the nasopharynx of bacterial or fungal origin;
recurring inflammation of the lymph nodes;
immunodeficiency syndrome;
refractory respiratory infections.

A significant role in reducing immunity is played by unfavorable social, environmental factors, and an unhealthy lifestyle:

food poor in proteins, fats, vitamins;
lack of mobility or excessive physical activity;
prolonged stay in a stressful situation;
emotional instability;
lack of normal rest;
addiction to alcohol, smoking, drug addiction;
living in unfavorable environmental conditions.

These factors, combined with autoimmune disorders, complicate the course of a viral disease. Under such conditions, mononucleosis without fever in a child may be accompanied by skin rashes.

Methods for treating and relieving fever

Therapy of mononucleosis involves the elimination of the manifestations of the disease, since it is impossible to completely destroy the virus. Prescribing treatment, doctors do not forget about the prevention of possible complications. Most often, complications occur when a bacterial infection joins a viral infection.

In the acute period, the patient with mononucleosis is advised to stay in bed.

It is important not to forget to gargle with antiseptic solutions. Furacilin, Chlorhexidine, Iodinol are suitable for this. You can use a decoction of chamomile, sage, calendula, eucalyptus. The nose is washed with saline or solutions based on sea salt. The procedure should be done at least 4-5 times daily.

In case of complications provoked by a bacterial infection, patients are prescribed antimicrobial agents. In a severe form of the disease, accompanied by a violation of the function of the respiratory organs, hormonal preparations (glucocorticoids) are prescribed, and antiallergic drugs are also prescribed.

Medicines based on paracetamol, ibuprofen help relieve fever. The dosage and frequency of taking antipyretics is recommended by the doctor, taking into account the age of the patient.

In order to strengthen the immune defense, it is recommended to take immunomodulators of natural origin. These are preparations based on echinacea, Icelandic cetraria. An obligatory part of the treatment is the intake of vitamin and mineral complexes. Good nutrition plays an important role in recovery.

Temperature after mononucleosis

How long the fever persists after mononucleosis in a child or adult depends on the individual characteristics of the organism. Many recovered patients note that the temperature after mononucleosis remains at the level of subfebrile condition for up to three months. At the beginning of the day, as a rule, it is normal, and in the evening it rises to 37.2-37.3 degrees.

Mononucleosis infection with timely and proper treatment rarely leads to serious complications. But if you do not pay attention to the malaise, then there is a high risk of rupture of the spleen, toxic hepatitis, problems in the hematopoietic and immune systems. Therefore, it is important to seek help from a doctor when the first symptoms appear.

Article author: Elena Lobashova, physician and psychologist. In 1997 she graduated from the Cherkasy Medical School with a degree in nursing. She worked for 5 years in the regional cardiological dispensary. In 2005 she graduated from the Rivne Institute of Slavic Studies of the Kyiv Slavic University. From 2002 to 2010 she worked as an instructor in health education at the Rivne Regional Health Center. Since 2010, she has been the head of the organizational and methodological department, a medical psychologist.

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

Infectious mononucleosis is caused 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.

The reservoir and source of infection is a sick person or a carrier of an infection. An infectious disease doctor treats mononucleosis. Epstein-Barr viruses in a latent form are stored in B-lymphocytes and in the epithelium of the mucous membrane of the oropharynx.

What is mononucleosis

Infectious mononucleosis is found everywhere and affects people of all age groups. In developed countries, the disease is recorded mainly among adolescents and young people, peak incidence falls on 14-16 years for girls and 16-18 years for boys. In developing countries, children of younger age groups are more likely to get sick.

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, as a rule, is not diagnosed due to the latent course. Infectious mononucleosis slightly contagious: mostly sporadic cases, occasionally small epidemic outbreaks.

Symptoms of mononucleosis

Disease develops gradually with fever and severe sore throat: there is a sore throat. Patients complain of well-being, loss of strength and loss of appetite. Typically, smokers lose their desire to smoke.

Cervical, axillary and inguinal lymph nodes gradually increase, swelling becomes visible. Inflammation of the cervical lymph nodes(cervical lymphadenitis), as well as tonsillitis, are typical signs of infectious mononucleosis.

Enlarged lymph nodes are elastic and painful on palpation. Sometimes body temperature reaches 39.4–40°. The temperature is kept at a constant level or fluctuates during the day, decreasing at times (in the morning) to normal. When the temperature rises, headaches are noted, sometimes severe.

From the first days of illness sizes increase liver and spleen, reaching a maximum by 4-10 days. Sometimes there are dyspepsia, abdominal pain. 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 the activity of transaminases in the blood is detected, which indicates a violation of liver function. At the height of the disease or at the beginning of the convalescence period, patients receiving antibiotics develop an allergic rash (maculopapular, urticarial, or hemorrhagic). More often this happens when penicillin drugs, 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 raids on the tonsils gradually disappear, later the hemogram, the size of the lymph nodes, spleen and liver are normalized.

In some patients, a few days after the decrease in body temperature, it rising again. Hemogram changes 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 the sacral region, in the joints.

Then there is laryngitis, dry cough, sore throat, fever. During this early period, the disease is diagnosed as influenza. In some children, these symptoms disappear after a few days. Careful clinical observation states an increase and soreness 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, 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 proceed without features (catarrh of the nose or throat), in others - tonsillitis, which sometimes takes on an ulcerative and even diphtheria character. The changes that have occurred in the throat and tonsils become the gateway for a secondary infection, sometimes proceeding septically.

A typical symptom of mononucleosis is rash on the palate. In addition, in addition to the symptoms of angina, some children develop swelling of the soft palate, tongue and larynx, as well as swelling of the oral mucosa. Gums soften, bleed, ulcerate.

Sometimes there is inflammation of the cornea of the eyes and the mucous membrane of the eyelids. The temperature is holding 10-17 days, in some cases up to a month. Sometimes subfebrile temperature lasts for months.

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

Nodes increase 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 there is a symmetrical enlargement of the nodes. Abdominal pain, nausea, vomiting and diarrhea are associated with an increase in mesenteric nodes.

Descriptions of symptoms of mononucleosis

Diagnosis of mononucleosis

Infectious mononucleosis is diagnosed based on several tests:

Also, a prerequisite for the development of mononucleosis is considered the presence of mononuclear cells. These cells are found in the blood in mononucleosis and their number is increased by 10% of the norm. At the same time, mononuclear cells are not detected immediately after the onset of the disease - as a rule, 2 weeks after infection.

When a single blood test fails to identify the cause of the symptoms, the presence of antibodies to the Epstein-Barr virus is determined. Frequently ordered research PCR, which helps to get the result quickly. Sometimes a diagnosis is made to determine HIV infection, which manifests itself as mononucleosis.

To determine the causes of the resulting sore throat and differentiate from other diseases, an otolaryngologist is appointed to consult, who does a pharyngoscopy to help determine the cause of the disease.

Treatment of mononucleosis

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

Which doctors to contact for mononucleosis

Treatment of mononucleosis is symptomatic. Antiviral, antipyretic, anti-inflammatory drugs and immune boosters. Application Shown local antiseptics for disinfection of the mucous membrane of the throat.

It is allowed to use an anesthetic spray, solutions for rinsing the pharynx. If there is no allergy to bee products, honey is used. This remedy strengthens the immune system, softens the throat and fights bacteria.

Infectious mononucleosis is often complicated by viral infections - in this case, antibiotic therapy is performed. Patients need to be provided with plentiful fortified drink, dry and clean clothes, and attentive care. Due to liver damage often not recommended take antipyretics, such as paracetamol.

With severe hypertrophy of the tonsils and the threat of asphyxia, prednisone is prescribed for a short course. During treatment worth giving up from fatty, fried foods, hot sauces and seasonings, carbonated drinks, too hot food.

Medications

Important: means of the penicillin group are contraindicated.

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

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

Treatment of mononucleosis in children

Children with mild forms of mononucleosis are 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.

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

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

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

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

peas;
beans;
ice cream;
garlic.

After recovery, for 6 months, the child is observed by an infectious disease specialist so as not to miss complications from the blood. The transferred disease leaves behind stable immunity.

Instructions for use of drugs for mononucleosis

Recovery from mononucleosis

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

When children have a fever, they eat reluctantly, mostly they drink a lot - let it be sweet tea with lemon, non-acidic fruit drinks and compotes, natural juices without preservatives. When the temperature returns to normal, the child's appetite improves. Six months is required to follow the right diet so as not to overload the liver.

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

To prevent complications mononucleosis, children are required to follow some recommendations for six months:

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

Complications of mononucleosis

Typically, mononucleosis ends full recovery.

But sometimes there are serious complications:

febrile syndrome;
pneumonia;
uveitis.

Neurological complications

polyneuropathy;
encephalitis;
meningitis;
mental disorders.

Hematological complications

decrease in the number of platelets;
death of red blood cells;
a decrease in the number of white blood cells.

Spleen rupture

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

Causes of mononucleosis

Sources of the causative agent of infection are a person with infectious mononucleosis and a virus carrier. Infection occurs by airborne droplets, by direct contact (for example, by kissing), through household items contaminated with saliva.

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

How can you get mononucleosis

The source of infection is a sick person or a healthy virus carrier. The disease is not contagious, which means that not everyone who comes into contact with the sick person or the virus carrier becomes ill. You can get infected by kissing, using personal hygiene products together with the patient (towels, washcloths, children when exchanging toys), and by blood transfusion.

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

Half of the people suffer from infectious mononucleosis during adolescence: boys at 16-18 years old, girls at 14-16 years old, and the incidence rate drops further.

Persons older than 40 years of infectious mononucleosis are extremely rare. 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 not to get mononucleosis

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

To increase immunity, regularly do a set of hardening measures. Wash your face with cool water, walk around the house barefoot, take a contrast shower, gradually increasing the duration of the cold part of the procedure and lowering the temperature of the water. If doctors do not forbid, douse yourself with cold water in winter.

Try to lead a healthy lifestyle, give up bad habits. Include easily digestible foods with vitamins and microelements in your diet: citrus fruits, dairy and other products. Requires physical education, walks in the fresh air, exercises in the morning.

In consultation with the doctor, take drugs that increase immunity. Better of plant origin, for example, tincture of Eleutherococcus, ginseng, Schisandra chinensis.

Since mononucleosis is transmitted by airborne droplets, it is required to exclude contact with a sick person. People who have been in contact with him fall ill within twenty days, counting from the day of the last contact.

If a child who attends is ill kindergarten, it is required to carry out a thorough wet cleaning of the group room, using disinfectants. Shared items (dishes, toys) are also subject to disinfection.

to other children, attending the same group, as prescribed by the pediatrician, a specific immunoglobulin is administered to prevent the disease.

Questions and answers on the topic "Mononucleosis"

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

The child had been ill with mononucleosis a month ago, the lymph nodes are still enlarged. The temperature is 37, then 36.8

Daughter 11 years old. I got sick with mononucleosis a month ago, and the cervical lymph node passes 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 the temperature has again risen to 37.3 and the throat is reddened. Throughout the month, they took Cecloferon and Viferon. What to do for treatment now? Please tell me.

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

Tell me, what tests are needed to detect mononucleosis?

Blood analysis.

I am 29. Three weeks ago, the lymph node on the neck on the right side enlarged and fell ill, the next day the same with the left and the throat was very swollen. After 4 days, the throat passed, a strong cough began and the temperature rose to subfebrile. 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, subfebrile temperature again, after another 2 days, severe swelling of the throat and swollen lymph nodes throughout the body. At the same time, severe sweating at night for two weeks and a dry cough. Could it be mononucleosis?

The diagnosis of mononucleosis is based on laboratory tests.

I am 62 years old. At the end of July, I got a sore throat - I can’t cure it until now. I visited an ENT doctor. I passed the tests - the BARRA virus - 650. The doctor said that she had once had mononucleosis and very low immunity. Having found your site, I read that it is impossible to re-infect with mononucleosis, so why can't I cure my throat. And which doctor should I contact (at the moment I am rinsing alternately with chamomile, diluted alcohol infusion of propolis, tanzelgon and lugol) or is it all about immunity? And what would YOU recommend?

If the ENT did not prescribe treatment and paid attention to immunity, you need to contact an immunologist.

Whether there can be complications on joints after the mononucleosis transferred one month ago?

Unlikely.

On the seventh day, the child (daughter is almost 9 years old) has a temperature, the first 4 days it rose to 39.5. For the first 2 days, the child complained that it hurt to look and had a headache, usually with the flu, nothing else bothered him, they started taking Ingoverin. The throat turned red on the 4th day, but there was no plaque and no pain, the doctor examined and diagnosed ORS. However, on the evening of the 4th day, an ambulance was called, the doctor suspected mononucleosis, the child was taking an antibiotic, they had a general blood test, a large number of leukocytes, mononuclear cells were within the normal range (as the pediatrician said), lymph nodes were enlarged. On the 7th day (today) they 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, since, of course, we don’t want to be with the child in the infectious diseases department. Can you please tell me how long you need to stay in hospital? The nose is disturbing (breathing is difficult), there is no 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 baby is 1.6 months old. 4 days went to the nursery and fell ill with mononucleosis. For 7 days the temperature was under 40. We were admitted to the hospital. They pierced 7 days with antibiotics and continue to drink acyclovir. Now he is covered in pimples. What is it an allergy or so the disease is shown? 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. Report this to your doctor.

A 3-year-old child has had infectious mononucleosis, after which he has 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 acute respiratory viral infections in a child is not mononucleosis, but another reason (decreased immunity), which may have led to the fact that the child developed mononucleosis. Infectious mononucleosis does not have a long-term effect on the immune system and does not cause late complications. For the prevention of SARS, it is necessary to strengthen the immune system.

Tell me, please, a 14-year-old child has been ill with mononucleosis. How to determine if there are complications? Our friends advised us to donate blood for AST and ALT. is it necessary? And whether it is necessary to hand over on antibodies to mononuclear cells?

How long ago did your child have mononucleosis? Has the child been examined by a doctor? If the child has no complaints, there is 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 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 be the diet?

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

A 15-year-old boy suspected of infectious mononucleosis has been sick for 5 days: severe sore throat, nasal congestion, lack of appetite, severe weakness, headache, high temperature has been lasting for 4 days (38.7-39.1). I knock down with nurofen (2 days), take zinnat (2 days), tantum-verde, nazivin, aqualor, rinse. Before nurofen, she knocked down panadol (2 days). On palpation, the liver is enlarged, white plaque on the tonsils (false tonsillitis). Why does the temperature keep going up? Is it harmful to take Nurofen for more than 3 days? And how long can the high temperature last? Tomorrow we will hand over a general analysis of urine and blood.

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 with your doctor about this.

Six months ago, she was ill with infectious mononucleosis. She carried him on her feet, because she did not know. Then I just passed the tests for infections and found that I had been ill with them. There was a high temperature, cervical and occipital lymph nodes were enlarged. After that I felt fine. The infectious disease specialist said that I no longer need her treatment, and why the temperature is for other doctors to find out. I have now had a long-term sub-verity 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. Ordinary ORV. But it is impossible to sleep at night, the lymph nodes on the back of the head and ear have increased. Now I don't know what it is. With what it is connected!!! 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 an increase in body temperature, therefore, diagnosis is possible only with direct contact with a doctor who will find out the presence of other symptoms, as well as prescribe additional studies.

Can you please tell me if it is possible to vaccinate DPT and polymelitis for children (3 and 6 years old), if they are diagnosed with infectious mononucleosis, cytomegalovirus, we have been treating these infections for 2 years, but to no avail. There is no acute phase now. Prior to this, the immunologist gave a medical tap once, when the acute phase was, and the hematologist all the time gives a medical tap. From the kindergarten they require either a medical discharge or vaccination. I know that these infections are practically impossible to cure, only poisoning the body of children with medicines. The last time the youngest was prescribed vitamins (he has constantly inflamed lymph nodes in his neck). Now a re-examination is needed. But I don’t want to go, because I know that the analysis will show the same thing, and the treatment is the same.

Vaccinations in this case can be done.

How can you quickly and effectively raise the immunity of a child after mononucleosis?

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

My 12 year old son had a severe form of mononucleosis in June. We are currently taking cycloferon. Recently, the child began to complain of strong frequent heartbeats. In a calm state, without physical exertion, the pulse can reach 120 beats per minute with blood pressure in the range of 120/76 - 110/90. Cases of such a strong heartbeat occur even at night. Can these symptoms indicate any complication after the illness? Or is it something else? And which doctor should I contact?

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

Is it possible to get infectious mononucleosis again?

Recurrence is practically impossible.

My 12 year old son has mononucleosis. The acute stage of the disease has passed. Now we are recovering at home. I was constantly next to him, practically did not leave. I am 41 years old. Now I feel bad too. The temperature is kept at 37.3 - 37.8. Strong weakness. Sore throat, nose intermittently does not breathe. Feeling that this pain and discomfort wants to move into the ears. The eyes were very reddened. Can I now become a carrier of this virus or get mononucleosis myself?

The symptoms you describe 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 banal SARS common at this time of year (adenovirosis). We recommend symptomatic treatment of colds with folk remedies. If you notice the appearance of pain in the liver, 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 severe. The temperature reached 40.4. The symptoms of this disease are removed by traditional means. At this point in time is the 6th day of illness. The temperature is kept within 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 with a decrease in temperature, even at night. Can I treat this disease while staying at home? What are the risks associated with this disease?

In most cases, the course is favorable, 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 rupture of the spleen, so make sure that for some time after recovery, the child refrains from active games that can lead to a fall or injury to the abdomen.

Good afternoon

I want to express my deep gratitude to the doctor "Clinico" Natalia Alexandrovna, who advised us all this time, answered all my questions and clarified the diagnoses and appointments of pediatricians.

Child 4 years old. On May 10, the child was taken from the nursery with a temperature of 38.8 without any signs of SARS. gave Nurofen temperature dropped to 37.8. at 3 a.m. the temperature rose again to 38.8, put a cifecon candle, the temperature dropped to the morning of 36.6, on the morning of May 11, we went to see a pediatrician, they didn’t make a diagnosis, they said to observe it, because the symptoms were meager. At home, they observed the regime of drinking, airing, by the evening the temperature was 38.5, they gave Nurofen, the temperature returned to normal ... on Thursday, May 12, the temperature was 37.3. On Friday, the temperature fluctuated from 36.6 to 37.2 during the day, there was no runny nose, no cough, the throat was normal, the child was cheerful, appetite decreased. We were at the appointment with the pediatrician, we were discharged, with the words of a fast-passing infection.

Saturday, May 14 in the evening, the temperature was 36.9, but huge spots of urticaria appeared on the legs, they itch. On May 15, in the evening, the temperature was 38.8 urticaria on the legs. Panic overcame me and we went to the hospital. Passed a blood test. Told bacterial infection to take antibiotic.

They did an x-ray and everything was normal. The urticaria went away on its own without medication within an hour. The hospital recommended a urinalysis, abdominal ultrasound and various swabs from the nasopharynx. Diagnosis of acute nasopharyngitis, the doctor said that he could not see anything else. appointments: supraks 3 ml - 2 r / d, and isoprinosine 0.5 tab. - 3 r / d, the Doctor saw a slightly loose and red throat and that's it .... nothing else and at the same time the temperature is quite high.

May 16 4 am temperature 39.3 - antipyretic. Back to the pediatrician. The doctor examined him and said that it looks like they picked up another virus. All the recommendations given in the hospital do not make sense - this is a repeated viral infection. Canceled all appointments, but supraks because. nachili accept - continue. Gave direction to retake blood on May 17 and for an appointment on Wednesday May 18. The child feels well at temperatures up to 38.5. The temperature rises to 39 almost every 5-6 hours, at a temperature above 38.5 he is lethargic, freezes, his appetite is poor. No runny nose, no cough, throat as always.

The blood was retaken on May 17 and I decided to go to another pediatrician, maybe he will give an answer, what is it with the child (because one says a bacterial infection, and the other a viral one). We were received by a young lady. She recommended a urine test ... well, continue treatment confirmed a viral infection

On May 18, a blood test is ready for an appointment at 17.00. A call from the local pediatrician (she never calls us) ... you have VERY BAD BLOOD ... by the way, she is -

While for two days already the temperature of 38.5 was brought down once a day, it rose to this mark at 16.30 according to the schedule ... well, I think this is already better, since the temperature rises less often. What is important on the eve at night, with free nasal breathing, the child began to snore in his sleep. I decided to check the throat, my husband and I clearly saw white plaques on the tonsils of the child. We went for a consultation to Laura, the diagnosis was follicular tonsillitis. Despite the fact that the child’s throat does not hurt ... They came to see another pediatrician, she did not see any raids, but with such a blood test, she urgently went to the hospital. I did not agree, they sent me for a consultation with an infectious disease specialist. The doctor very carefully examined the child, there were no raids, looked at all the tests and suggested that it could be infectious mononucleosis, ordered tests and waited for us to see her every other day. In the evening at 23.00, the temperature was 38.5 - she gave Nurofen, an hour later 39.1 - she called an ambulance - the antipyretic worked only after an hour. - 38.4. The ambulance arrived and saw the raids... said the parents, well done big-eyed. But my throat doesn't hurt... They offered to go to the hospital, so I decided to go.

Arrived at 3 am. From the medical history: Temperature 37.4. Saturation -98%. General condition of moderate severity. Consciousness is clear. There are no microcirculation disorders. Peripheral lymph nodes are tonsillar up to 0.8-1.9 cm, posterior cervical, axillary small, elastic, painless. The skin is pale, skin impurity on the chest and abdomen, no distinct rash. Skin turgor is preserved. I have a white coated tongue, wet. Nasal breathing is slightly difficult, there is no discharge. There are no wheezes. The pharynx is moderately hyperemic, the tonsils are enlarged to 1-2 degrees, structural, in lacunae, white plaques on both sides. There is no swelling. The abdomen is soft, not swollen, painless. Sigma is not spasmodic. Liver + 1.0 cm below the edge of the costal arch. The sileen is not palpable. Meningeal signs are negative. There are no focal symptoms. Treatment with ibuprofen, solution of cefotaxime in mice, irrigation of the throat of a pyobacteriophage, protorgol in the nose.

On May 19, a clinical blood test: Erythrocytes 4.53, hemoglobin - 125, platelets - 470, hematocrit 38, Leukocytes 15.2 Eosinophils 1, stab 4%, segmented 54%, lymphocytes 25%, monocytes 6%, MSN 28, Mononuclear cells 8.

05/20/16 Blood: biliruin, aminotransferases - ABT lab. bilirubin total -8.7. there is no direct bilirubin. ALT 12.2, AST 35.7

19.05 Fat metabolism, sugar. proserine test. LE - cells. Glycem. pro on an empty stomach 4.11

20.05. Blood enzymes, hormones, samples - ABT lab. Alkaline phosphase 399.5

19.05 Blood lactate 1.91

19.05. urinalysis (I will not describe) - everything is normal

05/20/16 Culture from the pharynx for b-hemolytic streptococcus is positive.

Throat smear for Liffler's bacillus Result - 3 893-4-

Diagnosis: infectious mononucleosis, moderate severity.

On May 21, with improvement, we asked to go home. The temperature returned to normal. The child feels well.

I hope our example will help young mothers. This is how mononucleosis proceeded with us, it all goes differently for us, for others it may be asymptomatic. It is a pity that it can be diagnosed only on the 10th day of the disease, how many nerves and experiences there were during these days.

The causative agent of the disease - the Epstein-Barr virus, abbreviated as EBV, is involved in autoimmune and malignant processes in the body (as scientists suggest). When infectious mononucleosis in children is acute, with a high temperature, the prognosis for recovery is good even in this case. Serious complications of a common infection are rare. Sick children complain of sore throat, weakness for several days, enlarged lymph nodes in the neck are noticeable on examination.

From the moment the Epstein-Barr virus enters the child's body, it takes 7–14 days for signs of infection to appear. The incubation period in adolescents is on average 28–30 days. According to the severity of manifestation and duration of clinical symptoms, acute infectious mononucleosis in children is distinguished, in which no more than three months pass from the first day to cure. The chronic form is associated with a long course of the disease and lasts more than 3 months.

The brightness of the symptoms, as shown by recent studies of scientists, depends little on the activity of the virus. Everything that happens to the patient is due to the strength of the response of his immune system to the introduction of infectious agents. Allocate the main and secondary symptoms of the disease. In an acute course in a child, against the background of complete well-being with health, the temperature suddenly rises to 38-40 ° C. The lymph nodes on the neck increase, a purulent plaque appears on the tonsils.

Triad The main symptoms of the disease in acute form are fever, pharyngitis and lymphadenitis.

Additional symptoms of infectious mononucleosis in children:

nasal congestion, sneezing, runny nose;
jaundice (rare);
swelling of the eyelids, face,
rashes;
diarrhea (rare).

In other cases, body temperature rises, but not at the very beginning of the disease. The child may complain of fatigue, burning, and mild pain in the oropharynx. The peak of the immune response gives a sharp rise in temperature, an increase in catarrhal symptoms. There is pain, swelling in the area of the lymph nodes and surrounding tissues. If the spread of infection in the body affects the liver, then yellowness of the skin and sclera is noted. Teenagers may complain of pain in the knee joints.

The course of the disease

Infectious mononucleosis is referred to by the old school as "glandular fever." This disease is characterized by lymphadenopathy, tonsillitis, enlargement of the spleen. In chronic course, experts note changes in the hemogram.

The child, in addition to the local pediatrician, should be examined by other doctors. It is necessary to visit an ENT-office, an immunologist and several other specialists.

The "classic" onset of acute viral mononucleosis in children is the onset of flu-like symptoms. The temperature rises to 39–40 ° C, headaches, discomfort in the throat, body aches and fatigue appear. Lymph nodes ache and swell - mainly in the neck, on the line of the lower jaw. May disturb the lymph nodes under the armpits or in the groin.

The duration of symptoms and treatment of the disease varies:

Acute mononucleosis lasts on average about 2 weeks.
Between 20 and 50% of children recover within 10 to 14 days and can return to kindergarten or return to school.
Only 1–2% of the total number of young patients get sick for several weeks or months.
About 1% are deaths.

Infectious mononucleosis is characterized by pain when swallowing, general malaise, as in bacterial tonsillitis. In about half of the cases in children, swollen tonsils are raspberry-colored and covered with a whitish-gray coating. There may be small hemorrhages on the hard palate, redness of the skin, itchy rashes.

Complications of infectious mononucleosis

Approximately one in ten children develop bacterial complications of infectious mononucleosis. An enlarged spleen is more common in older children. Serious but rare complications include meningitis or meningoencephalitis, myocarditis, airway obstruction.

The severity of symptoms practically does not affect the frequency and nature of complications. Most children fully recover from the acute form of the disease. A person who has had infectious mononucleosis remains a carrier of the Epstein-Barr virus for life.

Among the possible negative consequences is the transition of the disease to a chronic form with periodic exacerbations.

Adult patients in the case of activation of the infection describe their condition as chronic fatigue syndrome. They complain of palpitations, tension in the neck and shoulders, muscle and joint pain, dizziness. Metabolic disorders are accompanied by nausea or constant hunger.

Examination and mode

Infection is possible through direct contact, with droplets of saliva and epithelial cells when coughing and sneezing (airborne). Infectious mononucleosis in most cases affects children and adolescents, much less often people over 50 years of age. Isolation of the virus in the acute course of the disease can persist for several months. However, with asymptomatic carriage in 15–20% of healthy people, a large number of viral particles were also found in saliva. The incubation period is about 14–50 days.

Lifelong latent infection of B-lymphocytes causes the first contact with the virus. However, clinical symptoms do not always appear.

The prevalence of infection worldwide reaches 90% or more. The disease most often affects children - from infants to schoolchildren. The peak, namely 30-60% of cases of the clinical picture, falls on the age of 15 to 20 years.

Parents may think that the child has a common cold or purulent sore throat. At the beginning, laboratory diagnostics will show typical signs of inflammation, leukocytosis, and an increase in ESR are observed. The number of leukocytes occasionally remains at the normal level. A general blood test for infectious mononucleosis in children will reveal atypical lymphocytes only at the end of the first week. Laboratory diagnostics will allow you to determine antibodies to different genotypes of herpes viruses. Find and determine viral DNA in blood, saliva and urine.

It is important that the child observe a sparing regimen. Give the patient dietary meals, a sufficient amount of liquid.

Inpatient treatment of children is carried out in the infectious diseases department. Mild cases can be treated as outpatients. To avoid rupture of the spleen, limit the child's participation in certain sports for one month after recovery. For children who have had infectious mononucleosis, exercise restrictions may be extended for up to 3 months.

Treatment of acute mononucleosis

Conduct detoxification therapy, give the child desensitizing and restorative drugs. Symptomatic treatment of infectious mononucleosis in children includes taking antipyretics. non-steroidal anti-inflammatory drugs (ibuprofen).

Local antiseptics, in particular Geksoral, Bioparox, relieve pain and inflammation in the throat. Solutions without ethanol are best suited - chamomile infusion, furatsilin, iodinol. Assign a diet for febrile patients (No. 13), table No. 5 for hepatitis. The child should drink a lot - tea, natural juices, fruit drinks.

Appointment for treatment inf. mononucleosis in children antiviral drugs, immunomodulators - the prerogative of the doctor.

With complications of the disease, Viferon, Acyclovir or Ganciclovir are indicated. Antivirals are nephrotoxic and affect the bone marrow. It is important to remember that the problem is not so much the presence of the mononucleosis virus in children, but the acute reaction of the immune system to the infection. Both agents are interconnected: strengthening the immune system leads to a weakening of the virus and vice versa.

Antibiotics do not help fight a viral infection and often cause side effects. Antibiotic therapy is indicated for complications - bacterial tonsillitis, pneumonia, otitis media, meningitis. Preferably new generation drugs from the classes of macrolides, cephalosporins. Ampicillin, amoxicillin, chloramphenicol, sulfonamides are contraindicated.

Hormone therapy is carried out in a short course, only in cases of serious complications. Although corticosteroids reduce the intensity of the inflammatory process and alleviate the symptoms of pharyngitis, they have an immunosuppressive effect. Alternative remedies for the treatment of infectious mononucleosis can be found among homeopathic remedies that are intended for the treatment of herpes.

Glandular fever is one of the most common viral infections

Pediatrician Emil Pfeiffer first described the disease in 1889. The term "infectious mononucleosis" was proposed in 1920, and in 1932, heterophilic antibodies typical of mononucleosis were discovered. The virus was studied by the British Epstein and Barr in 1964 using electron microscopy.

The causative agent of EBV is transmitted by airborne droplets and directly through saliva. There is another name for the infection - "kissing disease". A less common route of infection is through sexual contact. After age 40, 90 to 98% of all people are EBV carriers. The virus infects B-lymphocytes in the epithelium of the oral cavity and nasopharynx, then the infection enters the tissues of the lymph nodes, spleen and liver.

In asymptomatic mononucleosis, EBV remains lifelong in target cells after infection.

We need to take seriously the mantra-sounding calls to strengthen the immune system. Researchers believe that the severity of infectious mononucleosis in children and adults is mainly due to the strength of the response of T-lymphocytes to the introduction of the pathogen. When the reaction is fast and effective, the primary infection is suppressed, the virus goes into a latent state.

EBV - the cause of autoimmune diseases, cancer and chronic fatigue syndrome?

Scientists at a cancer research center in Germany have discovered the existence of several strains of the Epstein-Barr virus, which differ in their degree of aggressiveness. According to Western experts, about 95% of the population of Central Europe are infected with EBV. Differences in symptoms are very significant, which is explained by the degree of response of the immune system. Previous courses of antibiotic therapy, gastrointestinal infections, stress also affect. The main destructive work of EBV in the body is aimed at the mechanisms of immunity.

Viruses block the protective reactions of the body that prevent the introduction and reproduction of the pathogen in the cells.

Perhaps the Epstein-Barr virus is the missing link in understanding the causes of the development of chronic fatigue syndrome on the way to the creation of effective drugs. In any case, the characteristics of the virus, the existence of different strains, should be taken into account by doctors in the diagnosis, when specialists decide how to treat small and adult patients.