Infectious mononucleosis severe form of treatment. What is mononucleosis and how is it treated?

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 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.

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 individuals young age, 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 often ill.

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 cervical lymph nodes (cervical lymphadenitis), as well as tonsillitis, are typical features 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 allergic rash(maculopapular, urticarial or hemorrhagic). More often this happens when 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 raids on the tonsils gradually disappear, later the hemogram, dimensions are normalized. lymph nodes, spleen and liver.

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 sacral region, in the joints.

Then there is laryngitis, dry cough, sore throat, fever. In that 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 lasts for months subfebrile temperature.

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 prerequisite 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. 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 condiments, carbonated drinks, too hot food.

Medications

Important: facilities penicillin group 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 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.

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 special diet, which is required to comply 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, 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 hold 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 required to comply proper 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 on fresh air, favorably affects the recovery after the disease stay in the village or in the country.

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, with direct contact (for example, with a kiss), through saliva-contaminated household items.

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 past 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 people carry infectious mononucleosis in adolescence: boys at 16-18 years old, girls at 14-16 years old, in the future, the incidence rate falls.

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 barefoot around the house, take cold and hot 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 healthy lifestyle life, give up bad habits. Include in your diet easily digestible foods with vitamins and microelements: 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 plant origin, for example, tincture of eleutherococcus, ginseng, magnolia vine.

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 premises, using disinfectants. Items sharing(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) rather 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, a lymph node in my neck enlarged and fell ill with right side, the next day the same with the left and the throat was very swollen. After 4 days, the throat went away, it began coughing 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 lymph nodes returned to normal. After 4 days again subfebrile temperature, after another 2 days severe swelling throat and swollen lymph nodes all over the body. Wherein heavy sweating at night for two weeks and 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. When I found your site I read that recurrence mononucleosis is impossible, why can't I cure my throat. And which doctor should I contact this moment I rinse alternately with chamomile, diluted alcohol infusion 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, because in infectious department I really don't want to be with a child. 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 for 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, which 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 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 sick for 5 days: strong pain in the throat, nasal congestion, lack of appetite, severe weakness, headache, the high temperature has been holding 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 coating on the tonsils (fol. angina). 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 calm state, without physical exertion, the pulse can reach 120 beats per minute with blood pressure within 120/76 - 110/90. Cases of such strong heartbeat happen 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. Acute stage 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. severe 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. Symptoms this disease filming 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 proceeds favorably, which makes possible treatment 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.

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 the composition of the blood.

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

As a rule, the clinical picture of infectious mononucleosis develops in young people: the peak incidence in girls is observed at 14-16 years, and the maximum infection among boys is observed at 16-18 years. 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 be selective or complex, begins with a sharp rise in body temperature, swelling of the cervical lymph nodes, difficulty in nasal breathing and tonsillitis. These signs of the disease usually develop in full by the end of the first week. On initial stage most patients also have such symptoms of infectious mononucleosis as the presence of peculiar lymphocytes (atypical mononuclear cells) in the blood, as well as an increase in the liver and spleen.

The disease can begin gradually: general malaise, slight temperature 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 the temperature is absent throughout the entire period of infectious mononucleosis are very rare.

Important, very often the first symptom of infectious mononucleosis is an increase in lymph nodes, especially cervical. 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.

Oropharyngeal injury - persistent symptom infectious mononucleosis. Patients have swelling and enlargement of the palatine tonsils, damage to the nasopharyngeal tonsil, which, in turn, causes difficulty in nasal breathing, severe nasal congestion, tightness of the voice, "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, they appear only after the restoration of nasal breathing. Patients have swelling of the posterior pharyngeal wall, which is usually covered thick mucus. During the illness, there is a moderate hyperemia of the pharynx and a slight sore throat.

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 3rd-4th day of illness) causes an even greater increase in temperature and a deterioration in the general condition.

An increase in the liver and spleen is observed in 97-98% of patients. A change in the size of the liver sometimes provokes the appearance of yellowness 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 the 4th-10th day, the liver returns to its normal size only by the end of the first - the beginning of the second month of the disease.

Often, 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 violations on the part of of cardio-vascular system like tachycardia, systolic murmur, muffled heart tones.

Infectious mononucleosis in children is not characterized by a chronic course and relapses. Complications in patients are most often due to the activation of the microbial flora, as well as the layering of SARS, otitis, pneumonia, bronchitis. Pancreatitis, orchitis and parotitis are considered rare complications of the disease. In 80% of cases, infectious mononucleosis is completely cured in 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 disease is possible only in isolated cases - from rupture of the spleen, severe lesions nervous system, with genetic insufficiency of the lymphatic system.

Treatment of infectious mononucleosis

There is currently no specific treatment for infectious mononucleosis.

The patient is recommended to drink plenty of water, bed rest, a diet that involves the exclusion of fried and fatty foods, hot spices. Symptomatic treatment of infectious mononucleosis includes taking vitamins, using hyposensitizing agents (reducing sensitivity to an 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 stimulants for the production of interferon - tinctures of lemongrass, ginseng, zamaniha, arapia, sterculia.

P In infectious mononucleosis, it is recommended to use neovir, which is an antibacterial, antiviral and immunomodulatory agent. Sulfanilamide preparations for this disease are not prescribed. Antibiotics can be recommended only in case of attachment of secondary microflora. In the treatment of severe forms of the disease, short courses are used corticosteroids, 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 injury to the spleen.

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.

Because no vaccine has been developed for infectious mononucleosis, there is no active immunization against the disease.

Video from YouTube on the topic of the article:

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

Complications

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

Diagnostics

Nonspecific laboratory diagnostics includes a thorough study of the cellular composition of the blood. A complete blood count shows moderate leukocytosis with a predominance of lymphocytes and monocytes and relative neutropenia, a shift of the leukocyte formula to the left. Large cells of various shapes with a 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 elements of white blood. When examining blood in the first days, mononuclear cells may be absent, which, however, does not exclude the diagnosis. Sometimes the formation of these cells can take 2-3 weeks. The blood picture usually gradually returns to normal during the period of convalescence, while atypical mononuclear cells often persist.

Specific virological diagnostics is not used due to laboriousness and irrationality, although it is possible to isolate the virus in the swab 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 determined during the period of incubation, and at the height of the disease are noted 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 the infection has been transferred, specific immunoglobulins G are present in the blood, which persist for life.

Patients with infectious mononucleosis (or persons suspected of having this infection) are subjected to three times (for the first time - during the period of acute infection, and with an interval of three months - twice more) serological testing for the detection of HIV infection, since it can also show the presence of mononuclear cells in the blood. For differential diagnosis angina with infectious mononucleosis from angina of another etiology, consultation with an otolaryngologist and pharyngoscopy is necessary.

Treatment of infectious mononucleosis

Infectious mononucleosis of mild and moderate course is treated on an outpatient basis, bed rest is recommended in case of severe intoxication, severe fever. If there are signs of impaired liver function, 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, the threat of asphyxia when the larynx is clamped by hyperplastic tonsils are an indication for the short-term appointment of prednisolone.

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

Forecast and prevention

Uncomplicated infectious mononucleosis has a favorable prognosis, dangerous complications that can significantly aggravate it, with this disease occurring quite rarely. 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 infections, individual measures are not specific prevention consist in increasing immunity, both with the help of general recreational activities, and with the use of mild immunoregulators and adaptogens in the absence of contraindications. Specific prophylaxis (vaccination) for mononucleosis has not been developed. Measures emergency prevention applied in relation to children who communicated with the patient, are in the appointment specific immunoglobulin. In the focus of the disease, a thorough wet cleaning is carried out, 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 (Berne J., 1909; Taidi G. et al., 1923; Schwartz E., 1929, and others). In accordance with these characteristic changes American scientists T. Sprant and F. Evans called the disease infectious mononucleosis. The causative agent was first identified by the English pathologist M.A. Epstein and Canadian virologist I. Barr from Burkitt's lymphoma cells (1964). The virus was later named the Epstein-Barr virus.

What provokes / Causes of Infectious mononucleosis:

The causative agent of infectious mononucleosis- DNA-genomic virus of the genus Lymphocryptovirus of the subfamily Gammaherpesvirinae 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 certain sequence and induces the synthesis of the corresponding antibodies. In the blood of patients with infectious mononucleosis, antibodies to the capsid antigen first appear, and later antibodies to EA and MA are produced. The causative agent is unstable in the external environment and quickly dies when dried, under the influence of high temperature and disinfectants.

Infectious mononucleosis is only one form of Epstein-Barr virus infection, 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 also detect the virus. The epidemic process is supported by persons who have previously had an infection and have been excreting the pathogen with saliva for a long time.

Transfer mechanism- aerosol, transmission route - airborne. Very often, the virus is excreted with saliva, so infection is possible by contact (with kisses, sexual contact, through hands, toys and household items). It is possible to transmit the infection during blood transfusions, as well as during childbirth.

Natural susceptibility of people high, however, dominated by light and erased forms illness. The presence of innate passive immunity may be evidenced by the extremely low incidence of children in the first year of life. Immunodeficiency states contribute to the generalization of infection.

Main epidemiological signs. The disease is ubiquitous; mostly sporadic cases are recorded, sometimes small outbreaks. The polymorphism of the clinical picture, the rather frequent difficulties in diagnosing the disease give reason to believe that the level of officially registered incidence in Ukraine does not reflect the true breadth of the spread of the infection. Adolescents most often get sick, in girls the maximum incidence is recorded at 14-16 years old, in boys - at 16-18 years old. Therefore, sometimes infectious mononucleosis is also called the disease of "students". Persons older than 40 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 flows 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 often - in the summer months. Infection is facilitated by crowding, the use of common linen, dishes, 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. Note the swelling of the mucous membrane, an increase in the tonsils and regional lymph nodes. 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, edema of the mucous membrane of the turbinates and oropharynx develop, the liver and spleen increase. Histologically revealed hyperplasia of lymphoreticular tissue 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 plasma cells. The latter secrete immunoglobulins of low specificity. Simultaneously in acute period diseases, the number and activity of T-lymphocytes increase. T-suppressors inhibit the proliferation and differentiation of B-lymphocytes. Cytotoxic T-lymphocytes destroy virus-infected 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 a decrease in immunity.

expressiveness immunological reactions with infectious mononucleosis allows us to consider it a disease of the immune system, therefore it is referred to the 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, fatigue, catarrhal phenomena in the upper respiratory tract - nasal congestion, hyperemia of the mucous membrane of the oropharynx, enlargement and hyperemia of the tonsils.

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

By the end of the first week of the disease, a period of the height of the disease develops. The appearance of all major clinical syndromes is characteristic: general toxic effects, tonsillitis, lymphadenopathy, hepatolienal syndrome. The patient's condition worsens high temperature body, chills, headache and body aches. Nasal congestion with difficulty in nasal breathing, nasal voice may appear. Throat lesions are manifested by an increase in sore throat, development of angina in catarrhal, ulcerative-necrotic, follicular or membranous form. Hyperemia of the mucous membrane is not pronounced, loose yellowish, easily removable plaques appear on the tonsils. In some cases, raids may resemble diphtheria. Hemorrhagic elements may appear on the mucous membrane of the soft palate, back wall pharynx sharply hyperemic, loosened, granular, with hyperplastic follicles.

Developing from the very first days lymphadenopathy. Enlarged lymph nodes can be found in all areas accessible to palpation; the symmetry of their lesions is characteristic. Most often, with mononucleosis, the occipital, submandibular, and especially the posterior cervical lymph nodes increase on both sides along the sternocleidomastoid muscles. Lymph nodes are compacted, mobile, painless or slightly painful on palpation. Their sizes vary from a pea to a walnut. Subcutaneous tissue around the lymph nodes in some cases may be edematous.

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

Sometimes there is a maculopapular exanthema. It does not have a 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, lasting an average of 2-3 weeks, comes convalescence period. The patient's state of health improves, body temperature normalizes, tonsillitis and hepatolienal syndrome gradually disappear. In the future, the size of the lymph nodes is normalized. The duration of the convalescence period is individual, sometimes subfebrile body temperature and lymphadenopathy persist for several weeks.

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

Clinical manifestations of infectious mononucleosis in adult patients differ in a number of features. The disease often begins with a gradual development of prodromal phenomena, fever often persists for more than 2 weeks, the severity of lymphadenopathy and hyperplasia of the tonsils is less than in children. At the same time, in adults, manifestations of the disease associated with involvement in the process of the liver 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 divisions respiratory tract with enlarged tonsils. IN rare cases noted bilateral interstitial infiltration of the lungs with severe hypoxia, severe hepatitis (in children), thrombocytopenia, spleen ruptures. In most cases, the prognosis of the disease is favorable.

Diagnosis of infectious mononucleosis:

Infectious mononucleosis should be distinguished from lymphogranulomatosis and lymphocytic leukemia, coccal tonsillitis 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, polyadenopathies (especially with lymph nodes affected along the sternocleidomastoid muscles on both sides), hepatolienal syndrome, specific changes in the hemogram. In some cases, jaundice and (or) maculopapular exanthema may occur.

Laboratory diagnosis of infectious mononucleosis
Most feature- changes in the cellular composition of the blood. The hemogram reveals moderate leukocytosis, relative neutropenia with a shift of the leukocyte formula to the left, a significant increase in the number of lymphocytes and monocytes (more than 60% in total). In the blood there are atypical mononuclear cells - cells with a wide basophilic cytoplasm, having different shape. Their presence in the blood determined modern name illness. Of diagnostic value is an increase in the number of atypical mononuclear cells with a wide cytoplasm of at least 10-12%, 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 of the disease does not contradict the proposed 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; in the future, they are detected in all patients (this serves as a reliable confirmation of the diagnosis). IgM to VCA antigens disappear only 2-3 months after recovery. After the disease, IgG to VCA antigens are stored for life.

In the absence of the possibility of determining anti-VCA-IgM, serological methods for the detection of heterophilic antibodies are still used. They are formed as a result of polyclonal activation of B-lymphocytes. The most popular are the Paul-Bunnel reaction with ram 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 given 3 times (in the acute period, then after 3 and 6 months) laboratory examination for antibodies to HIV antigens, since a mononucleosis-like syndrome is also possible at the stage of primary manifestations of HIV infection.

Treatment for 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 disease with manifestations of hepatitis, a diet is recommended (table No. 5).

Specific therapy has not been developed. Conduct detoxification therapy, desensitizing, symptomatic and restorative treatment, rinsing the oropharynx with antiseptic solutions. Antibiotics in the absence of bacterial complications are not prescribed. With a hypertoxic course of the disease, as well as with the threat of asphyxia due to edema of the pharynx and a pronounced increase in 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 SARS. Specific preventive measures have not been developed. Non-specific prophylaxis carry out increase in the general and immunological resistance of an organism.

Which doctors should you contact if you have Infectious Mononucleosis:

Are you worried about something? Do you want to know more detailed information about Infectious Mononucleosis, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can book an appointment with a doctor– clinic Eurolaboratory always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance and make a diagnosis. you also can call a doctor at home. Clinic Eurolaboratory open for you around the clock.

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Mononucleosis is an acute infection that affects the body's lymphatic system. The disease progresses from acute fever, sometimes enlarging the spleen and liver. It leads to the occurrence of angina, a decrease in immunity. It is now known for certain that the virus Epstein Barr infectious mononucleosis almost always causes. Doctors attribute it to the group of herpes. 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, so the infection was 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;
• transferred stress;
• non-observance of hygiene rules;
• use of shared linen, dishes, 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 the activity of microbes or their poisons in the human body. chills occur, increased sweating.
2. Angina. There is pain in the throat when swallowing, inflammatory process on mucous membranes and enlarged tonsils.
3. Damage to the lymph nodes. The lymph nodes and tissues around them are enlarged, usually under the jaw, which indicates the spread of the focus of infection.
4. Damage to the spleen and liver. This provokes the appearance in the abdomen pain varying degrees. By the 10th day of illness, jaundice may be observed. skin.
5. Rash on the skin. Disappears after fading acute symptoms mononucleosis.
6. Change in blood picture. It is diagnosed by a doctor after testing 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, pancreas. Occurs in severe forms of infectious mononucleosis in children with reduced immunity.

Methods for the treatment of mononucleosis disease

Viral mononucleosis refers to infections that are self-limiting, so even if untreated, 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, it is recommended that sick people undergo certain treatment by doctor's prescription. Mononucleosis is easily treated at home with bed rest and diet, but special therapy doctors have not yet developed against this disease.

Medical treatment

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

Folk remedies against the virus

The symptoms of viral mononucleosis are relieved by the following: folk recipes:

1. A decoction of cabbage. The presence of a large amount of vitamin C allows you to quickly relieve the symptoms of fever. To do this, wash the cabbage leaves, fill them with water and cook over low heat for 5 minutes. Then let the decoction infuse until cool, and take it 100 ml every hour until the body temperature drops.
2. To reduce pain in the throat, you need to rinse it with a decoction of chamomile and rose hips. To prepare it, take 150 g of dried chamomile flowers, 1 tbsp. l. pharmacy wild rose, 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 in case of 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 and put on water bath for 15 minutes. After the decoction has cooled, drink 150 ml 3 times a day until complete recovery.

Possible complications and consequences

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

Prognosis and prevention of the disease

In 90% of cases of detecting an infectious disease, mononucleosis has a favorable prognosis. However, after an infection, the body remains weak. Decreased immunity against the background of the disease can last up to 6 months, therefore it is indicated general strengthening body: regular washing throat and nose with decoctions of herbs, hardening, taking vitamin complexes, proper nutrition frequent exposure to fresh air.

Which doctor to contact to diagnose the disease

Mononucleosis is treated by an infectious disease specialist. This specialist is easy to find in any infectious diseases hospital of a city or district scale. The doctor is responsible for diagnosing and treating mononucleosis and other viral diseases. He studies the causes of the disease and the mechanism of infection in each individual case, determining clinical picture with the help of bacterial cultures, blood and urine tests, biochemical research, Ultrasound, x-ray, electrocardiography, irrigoscopy.

Video: how mononucleosis is transmitted and how to cure it

Children's mononucleosis often develops after the age of 10 years, and infants under 1 year of age practically do not get sick with this infectious disease. This is due to the fact that children at this age do not communicate with their 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, from where its journey through the body begins. Let's see in the video the opinion of the famous pediatrician Dr. Komarovsky on how best to treat infectious mononucleosis: