What is the mononucleosis virus afraid of? Infectious mononucleosis - treatment

Data Apr 02 ● Comments 0 ● Views

Doctor Dmitry Sedykh

Infectious mononucleosis is predominantly childhood disease, developing against the background of the activity of the Epstein-Barr virus (one of the types of herpes). In rare cases, pathology occurs in adults. Mononucleosis is treated with medicationssuppressing the herpes virus. The therapy regimen is selected taking into account the nature of the general symptoms.

In addition to the Epstein-Barr virus, either cytomegalovirus can be the causative agent of infectious mononucleosis. In rare cases, the pathology develops against the background of the activity of the three indicated infections.

Herperoviruses (herpes viruses), after entering the body, infect the cells of the central nervous system, as a result of which an exacerbation occurs when the body is affected by other diseases. Other factors that cause weakening of immunity can provoke pathology.

Herpes viruses enter the body mainly through direct contact with the carrier of the pathogen. The incubation period lasts up to 1.5 months. During this time period, the patient does not experience the discomfort associated with infection with viral agents. Less commonly, adults have the following symptoms:

• general weakness;
• bouts of nausea;
• increased fatigue;
• sore throat.

With infectious mononucleosis, inflammation of the tonsils and lymph nodes... The course of the pathology is accompanied by the following clinical phenomena:

• redness of the mucous membranes oral cavity;
• headaches;
• nasal congestion;
• chills;
• body aches;
• decreased appetite against the background of an increase in the frequency of nausea attacks.

These phenomena disturb the patient for 2-14 days. As the pathological process develops, other symptoms arise that make it possible to differentiate infectious mononucleosis with other pathologies:

• an increase in body temperature up to 38 degrees;
• normal work of the sweat glands, which is not typical for diseases with similar symptoms;
• slight increase in cervical lymph nodes;
• swelling and looseness of the tonsils, covered with a yellowish-gray bloom;
• hyperplastic changes in the mucous membrane of the throat.

Simultaneously with the above symptoms, a red rash occurs on the patient's body, localized in various areas.

Often, the course of infectious mononucleosis causes damage to the spleen and liver. Dysfunction of the latter causes pain, localized in the right hypochondrium, darkening of urine and jaundice. With damage to the spleen, an increase in the size of the organ is noted.

In the case of a secondary infection, the nature clinical picture varies depending on the type of pathogenic agent.

On average, it takes up to 1-2 weeks for a patient to fully recover. A febrile condition and enlarged cervical nodes can disturb for about one month.

Video about infectious mononucleosis. What are these, symptoms. Competent treatment.

How to treat mononucleosis with medication?

During the treatment of mononucleosis, bed rest must be observed until the patient's condition is fully recovered. Treatment of the disease is carried out at home. Hospitalization of the patient is necessary only in extreme cases, when the disease develops against the background of immunodeficiency.

A specific therapy for mononucleosis has not been developed. This is partly due to the fact that the disease occurs against the background of herperovirus activity, which cannot be completely cured.

In the treatment of infections that cause mononucleosis, an integrated approach is recommended. This pathology requires medical intervention. Treatment of the disease is carried out with antiviral agents that suppress the activity of any type of herperovirus:

1. Valtrex;
2. "Acyclovir";
3. "Groprinosin".

In case of an increase in body temperature, non-steroidal anti-inflammatory drugs are prescribed:

1. Ibuprofen;
2. "Paracetamol";
3. "Nimesulide".

These drugs suppress inflammatory process, thereby relieving the swelling of the tonsils. The latter is also stopped by antihistamines:

1. Suprastin;
2. Loratadin;
3. "Cetirizine".

Less often, patients are prescribed immunotherapy, which involves the introduction into the body of a specific immunoglobulin against the Epstein-Barr virus. In some cases, when the course of the disease is accompanied by signs of asphyxia, treatment is supplemented by taking glucocorticoids. These drugs should not be used without consulting a doctor. Failure to adhere to the dosage of glucocorticoids causes severe complications.

Often, the course of the disease is accompanied by a sore throat, in which antiseptic solutions "Furacilin", "Chlorhexidine" are prescribed. In order to strengthen general immunity, vitamin complexes or immunomodulators are prescribed.

Also in the treatment of mononucleosis, an antibiotic is used, which is prescribed in case of a secondary infection. More often, the activity of the latter is stopped with the help of antibacterial drugs of the ampicillin series. With liver damage, the use of hepatoprotectors is indicated.

How to treat mononucleosis with traditional medicine?

Traditional methods of treating mononucleosis in adults should not replace drug therapy. They are allowed to be used only after consultation with a doctor.

In the treatment of mononucleosis, the following traditional medicines are shown:

• echinacea tincture (strengthens the immune system);
• decoction of calamus or ginger (suppresses secondary infection, reduces the intensity of sore throat);
• broth of elderberry or dandelion (stops headache, strengthens the immune system).

When selecting traditional medicine, one should take into account the presence of individual intolerance to individual components of the selected drug.

How long does the disease take to heal?

The duration of treatment for infectious mononucleosis in adults directly depends on the patient's immune status. On average, complete recovery of the body takes about one month. Moreover, over the past weeks, the intensity of general symptoms is gradually decreasing. During this period, the patient is mainly concerned about certain clinical phenomena: enlarged lymph nodes, sore throat and others.

Infectious mononucleosis in adults takes longer to be treated if the drugs are incorrectly selected or the disease is caused by immunodeficiency.

What recommendations should be followed during treatment?

During therapy, it is important to limit the patient's communication with healthy people. In addition, it is recommended to use personal utensils.

With mild and moderate forms of pathology, an abundant drink is shown, which helps to eliminate toxins from the body. In case of liver damage, it is necessary to adjust the daily diet, giving up alcohol, fried fatty foods in favor of broths, kefir, yoghurts, natural juices.

To cure infectious mononucleosis, it is important to carry out complex therapy. Antiviral, antipyretic and antihistamines help to get rid of the symptoms of the disease.

With this also read

Mononucleosis refers to those diseases that in practice modern doctors are extremely rare. However, it should be noted that this is a very dangerous ailment. Especially when it comes to children. In addition, in most cases, the disease appears suddenly. So, we propose to find out what is hidden behind the diagnosis "mononucleosis", what kind of ailment it is and how to protect a child from illness.

Characteristic

According to statistics, mononucleosis in adults is extremely rare. Almost 90% of the population is immune to the Epstein-Barr virus, since this infection was carried during adolescence. The presence of antibodies in the blood indicates that they had to have had the disease at least once. Most often, the virus occurs in adolescents and children. Girls are most susceptible to this disease at the age of 14-16, and boys - at the age of 16-18.

What kind of disease is mononucleosis? This is an acute infectious disease caused by the Epstein-Barr virus. It is quite stable in the external environment. The virus causes a primary specific infection. For every 10 people who become infected with it, about 9 have a chronic form. It is not accompanied by acute episodes.

Thus, these people are lifelong carriers of the virus. They will never survive the acute form of the disease. At the same time, without getting sick themselves, carriers secrete the virus with saliva. That is why quite often the question: "Mononucleosis - what is it?", You can hear the answer: "Kissing disease."

This ailment has many names. For example: Filatov's disease, monocytic angina, Pfeiffer's disease, glandular fever, recruits' disease, Epstein-Barr virus infection, EBV infection, and kissing disease.

Description

Due to the low prevalence of the disease, few people know what kind of disease is mononucleosis. As noted above, this is an acute illness of a viral nature.

It manifests itself as a significant increase in temperature, damage to the lymph nodes and palatine tonsils. In addition, the disease leads to enlargement of the spleen and liver. The causative agent of the disease belongs to type 4 herpes viruses.

Its feature is the selective damage to the cells of the immune system. B-lymphocytes are affected by the virus. This leads to changes in those organs in which they are present - the spleen, lymph nodes, liver.

After mononucleosis, a person develops strong immunity. Repeatedly do not get sick.

Causes of pathology

The main source of the disease is people whose blood contains the Epstein-Barr virus. An infected person releases it into the external environment. Moreover, the virus is spread not only by patients with an open form. The erased form of mononucleosis is also dangerous. Studies have shown that for 18 months after infection, the virus is released into the environment. This happens even when there are no clinical manifestations.

The main route of distribution is airborne. However, this is not always the case. The virus can penetrate into the oropharynx of a healthy person and by household contact, for example, with a kiss. This happens much more often than when sneezing. In addition, the virus can enter the body through blood transfusions. It should be remembered (if we are talking about mononucleosis) that this is an infectious disease.

As soon as the virus enters the oral mucosa (the most favorable conditions for it), it penetrates the lymphocytes. This is where it reproduces. Throughout the body, the infection spreads by the hematogenous route, infecting it along the way and provoking the signs that characterize mononucleosis. Patient's symptoms indicate infection.

Characteristic signs

The incubation period of the disease is 4 to 6 weeks. In most cases, acute infectious mononucleosis begins. Symptoms characterizing the disease appear almost immediately.

The main signs of the disease are:

1. Headache.
2. Enlargement of the spleen and liver.
3. Inflammation of the lymph nodes.
4. Mononuclear angina (films of a dirty gray color appear on the tonsils, they can be easily removed with tweezers).
5. Swollen lymph nodes (palpation is painful enough, they can reach the size of an egg).
6. Joint and muscle pain.
7. Weakness.
8. Fever.
9. Herpes lesions may occur on the skin.
10. Loss of appetite.
11. Bleeding gums.
12. Sore throat.
13. Runny nose.
14. Nausea.
15. Nasal congestion.
16. Increased susceptibility to infections.

In this case, the main symptoms characterizing mononucleosis are severe fatigue, high fever, swelling of the lymph nodes and sore throat.

The ailment begins with general malaise, the duration of which varies from several days to a week. After that, there is an increase in temperature, a sore throat occurs, and lymph nodes increase. As noted above, it is these signs that are the symptoms that characterize infectious mononucleosis. The maximum body temperature sometimes reaches 39 degrees. The throat is quite inflamed, pus may appear on the back wall.

Forms of the disease

This disease is divided into two types:

1. Typical shape. This infectious mononucleosis in children is characterized by the symptoms described above.
2. Atypical form. With this form, some symptoms are absent. Sometimes there are manifestations uncharacteristic of the disease:

• An asymptomatic form can be diagnosed. In this case, the child is exclusively a carrier of the infection, which is detected only by laboratory methods.
• With an erased form, all signs of infection are poorly expressed. They disappear very quickly.
• The visceral form is characterized by damage and enlargement of internal organs.

Diagnosis of the disease

The following drugs are considered to be quite effective:

• "Arbidol";
• "Imudon";
• Anaferon;
• "Metronidazole".

With purulent deposits on the tonsils, it is advisable to introduce agents for treating the throat into therapy. Anti-inflammatory solutions and spray are effective. The appointment may include drugs:

• Hexoral;
• Tantum Verde.

If the symptoms of nasal congestion have provoked mononucleosis in children, it is recommended to regularly rinse it with solutions based on seawater. Some of the most effective means are:

• Aqua Maris;
• Salin;
• "Marimer";
• "Aqualor".

In addition, the nasal cavities must be instilled for about eight days with special drops. Effective in this case means "Protargol". The child will also need vasoconstrictor drugs. It is advisable to use drugs:

• "Tizine";
• "Rinonorm".

In case of a severe course of the disease, the doctor may prescribe glucocorticoids "Dexamethasone" and "Prednisolone", as well as probiotics "Bifidumbacterin", "Acipol".

It is imperative to control the humidity in the patient's room. This simple recommendation will make it much easier for your baby to breathe through the nose and avoid dry throat. If you are using a humidifier, it is helpful to add essential oil (best pine and eucalyptus).

Give your child plenty of warm drinks. This will protect him from the risk of dehydration.

It is very important to organize the baby proper nutrition... In no case should the spleen and liver be overloaded. The diet should include light meals fortified with vitamins. Fatty, sweet, salty, smoked, spicy foods are strictly prohibited.

A child is constantly tired if he is diagnosed with mononucleosis. Treatment involves more than just drug therapy. In this state, sleep is useful for the child. It will provide the body with a quick recovery.

It is important to remember that with this diagnosis, the child should be protected from physical exertion. In no case should damage to the abdomen be allowed, since mononucleosis in adults and in children provokes a significant increase in the spleen. The organ even begins to bulge out from under the ribs. Any trauma to this area can rupture the spleen.

How does Komarovsky advise treating mononucleosis? The famous doctor focuses on the following aspects:

• drinking plenty of fluids;
• fresh air;
• maintaining optimal humidity and temperature in the room.

Recovery period

Now you know what is meant by the diagnosis "mononucleosis", what kind of ailment it is. However, treatment does not end solely with symptom relief. The disease is very exhausting the body. High fever, painful, enlarged lymph nodes, a dangerous virus in the blood - all this takes away the strength of the patient. That is why children's organism needs long-term rehabilitation.

Thus, despite the fact that the child has recovered from an ailment such as mononucleosis, treatment in children must continue.

1. During the first month, the little patient does not feel very well, he can often complain of weakness, malaise. At this time, he especially needs rest and sleep.
2. Do not forget that for another six months the child is a carrier of the virus. Therefore, it is recommended to provide the baby with a separate dish. This will keep other family members from getting infected.
3. The doctor will recommend that you take control tests of urine and blood. It is very important to conduct such surveys. They will show the state of the child's body.
4. For recovery, the doctor will advise you to take a course of vitamin therapy. As a rule, a vitamin and mineral complex should be taken for a month. It can be: "Vitrum", "Multi-tabs", "Kinder Biovital".
5. Immunomodulatory drugs are required. They allow you to strengthen the body and avoid unwanted complications.

Effective immunomodulatory medications a child needs to rehabilitation period are:

1. Drops "Derinat". Provide restorative and strengthening functions of the nasal mucosa.
2. Candles "Viferon". It is an antiviral agent. It belongs to the category of interferons, has antiviral properties and restores immunity.
3. The drug "Imudon". It is an excellent immunomodulator, topical preparation. Designed for the prevention and treatment of oropharyngeal ailments.

Following these recommendations will allow you to restore the child's body much faster after a disease such as mononucleosis. Treatment should not be limited to just managing symptoms, but should continue into the recovery period.

Guys are freed from various preventive vaccinations... They need to limit physical activity. In addition, children who have had mononucleosis should be protected from sun exposure. In the coming summer, sunbathing should be extremely careful. Active sun is strictly contraindicated for such children.

A big plus is that when correct treatment and compliance with rehabilitation measures, the ailment is completely cured.

Diet food

Since infectious mononucleosis in children affects vital important organssuch as the liver and spleen, the baby needs sparing nutrition. The doctors appoint diet table number 5.

In this case, the dishes are cooked boiled or baked. It is advisable to take food 5-6 times a day.

1. Fruit and non-acidic berry juices. Tomato juice is useful. Jelly, compote are allowed. The diet includes weak tea, coffee with milk. It is recommended to use rosehip decoction.
2. Rye or wheat bread, only yesterday's baked goods. Uncooked cookies.
3. Whole milk, dry, condensed. A little sour cream, low-fat cottage cheese, mild cheese.
4. A variety of soups, exclusively on vegetable broth. Fruit and dairy products are useful.
5. Vegetable, butter - not more than 50 g per day is allowed.
6. Lean (low-fat) meats, boiled or baked.
7. Loose porridge. It is recommended to give preference to buckwheat and oatmeal.
8. Low-fat types of fish - pike perch, carp, cod, navaga, pike, silver hake. Exclusively in steam or boiled form.
9. Vegetables, herbs, especially tomatoes are useful. Non-sour sauerkraut is allowed.
10. The diet can include no more than one egg per day (in the form of an omelet).
11. Jam, honey. Sugar is allowed.
12. A variety of fruits and berries are useful. At the same time, acidic foods are unacceptable.

Diet food means eliminating the following food categories from the diet:

1. Fresh bread, baked goods. You should give up cakes, pancakes, fried pies.
2. Lard, cooking fats.
3. Soups based on meat, fish, mushroom broths.
4. Legumes, spinach, mushrooms, sorrel, green onions, radishes, radishes.
5. Fatty meat - pork, lamb, beef, duck, goose, chicken.
6. Hard boiled or fried eggs
7. Fatty fish - beluga, stellate sturgeon, sturgeon, catfish.
8. Canned food, pickled vegetables, caviar, smoked meats.
9. Sour berries and fruits, cranberries.
10. Pepper, horseradish, mustard.
11. Black coffee, cold drinks, cocoa.
12. Cream products, ice cream, chocolate.
13. Adults are advised to exclude alcoholic beverages.

Conclusion

Despite such unpleasant symptoms and a severe course of the disease, children who have suffered from infectious mononucleosis become owners of persistent immunity to it. Despite the fact that the virus persists forever in the body, it will never again subject a person who has suffered a disease to new torments, since there are almost no relapses of the disease.

The content of the article

Infectious mononucleosis (synonyms of the disease: glandular fever, Filatov's disease, Pfeiffer's disease, Türk's disease, monocytic tonsillitis, etc.) is an acute infectious disease of a viral nature, mainly with an airborne infection mechanism, characterized by fever, polyadenitis (especially cervical), acute tonsillitis with plaque, enlargement of the liver and spleen, leukocytosis, lymphomonocytosis, the presence of atypical mononuclear cells (virocytiv).

Historical data on infectious mononucleosis

In 1885 p. NF Filatov was the first to describe this disease as an independent nosological unit and gave it the name "idiopathic inflammation of the lymphatic glands." In 1889 p. E. Pfeiffer described the clinical picture of a disease called glandular fever. Since 1962, a single name for this disease has been used - infectious mononucleosis. In 1964 p. M. Epstein and J. Wagg isolated a herpes-like virus, which is found with high constancy in patients with infectious mononucleosis.

Etiology of infectious mononucleosis

Recently, the most probable is the viral nature of infectious mononucleosis. Most authors believe that the Epstein-Barr virus, which belongs to DNA-containing lymphoproliferative viruses, plays the main role in the etiology of infectious mononucleosis. The Epstein-Barr virus is shown not only in infectious mononucleosis, but in other diseases - Burkitt's lymphoma, in which it was first isolated, nasopharyngeal carcinoma, lymphogranulomatosis. Antibodies against this virus are also found in the blood of patients with systemic lupus erythematosus, sarcoidosis.

Epidemiology of infectious mononucleosis

The source of infection in infectious mononucleosis are patients and virus carriers. It is believed that the pathogen is contained in the secretion of the oral cavity and is excreted in saliva. Transmission mechanism - mainly airborne. The possibility of contact, alimentary and transfusion transmission of infection is not denied. Infectious mononucleosis is registered mainly in children (2-10 years old) and young people. At the age of over 35-40 years, the disease is almost not observed. The contagiousness of patients with infectious mononucleosis is relatively low. The incidence is sporadic. Epidemic outbreaks are rare. Seasonality has not been determined, but most cases of the disease occur during the cold season. Immunity after an illness is stable, as evidenced by the absence of repeated cases of the disease.

Pathogenesis and pathomorphology of infectious mononucleosis

The entrance gate of infection is the mucous membrane of the nasopharynx and upper respiratory tract. The virus of infectious mononucleosis is tropic to the lymphoid and reticular tissue, as a result of which the lymph nodes, liver, spleen, to a certain extent - the bone marrow, kidneys are affected. Lymphogenically, the pathogen enters the regional lymph nodes, where primary lymphadenitis develops. In case of destruction of the lymphatic barrier, viremia occurs and the process is generalized. The next phase of pathogenesis is infectious-allergic, which predetermines the undulating course of the disease. The last phase is the formation of immunity and recovery.
The defeat of the lymphoid and reticular tissue leads to an increase in the number of lymphocytes, monocytes and the presence of monocyte-like lymphocytes in the blood, which are called differently: atypical mononuclear cells, glandular fever cells, virocytes, and lymphocytes like plasmatization.
Recently, much attention has been paid to infectious mononucleosis as a disease of the immune system. The virus does not destroy infected cells (B-lymphocytes), but stimulates their reproduction; can peremetuvata in lymphocytes for a long time. Fixation of the pathogen on the surface of B-lymphocytes leads to the activation of the body's defense factors. These include circulating antibodies against the surface antigen of the Epstein-Barr virus, cytotoxic lymphocytes, natural killer cells. The main mechanism of destruction of infected cells in infectious mononucleosis is the formation of specific cytotoxic T-killers capable of recognizing infected cells. During the intense destruction of B-lymphocytes, it is possible that substances are released that predetermine fever and are toxic to the liver. In addition, a significant amount of viral antigens enter the lymph and bloodstream, causing a general allergic reaction slow type. Infectious mononucleosis is also characterized by the activation of T-lymphocytes - suppressors that suppress the reproduction and at the same time the differentiation of B-lymphocytes. This makes it impossible for infected cells to multiply.
Histologically, generalized hyperplasia of the lymphatic and reticular tissue of all organs and systems, as well as infiltration of a mononuclear nature, sometimes shallow focal necrosis in the liver, spleen, kidneys, and central nervous system are found.

Clinic of infectious mononucleosis

The incubation period for infectious mononucleosis ranges from 6-18 days (up to 30 -40 days). Sometimes the disease begins with a prodromal period lasting 2-3 days, during which fatigue, lethargy, loss of appetite, muscle pain, and dry cough appear.
In typical cases, the onset of the disease is acute, body temperature rises to 38-39 ° C. Patients complain of headache, runny nose, sore throat when swallowing, sweating.
Already in the first 3-5 days, characteristic clinical signs diseases: fever, tonsillitis (acute tonsillitis), enlarged lymph nodes, difficulty in nasal breathing, enlarged liver and spleen.
Attention is drawn to the characteristic appearance of the patient for infectious mononucleosis - swollen eyelids and eyebrows, nasal congestion, a half-open mouth, dryness and redness of the lips, the head is slightly thrown back, hoarse breathing, a noticeable increase in lymph nodes. Fever in infectious mononucleosis can be persistent, remitting or irregular, sometimes wavy. The duration of the febrile period is from 4-5 days to 2-4 weeks or more.
Lymphadenopathy is the most persistent symptom of the disease. First of all, the cervical lymph nodes are enlarged, especially those located along the posterior edge of the sternocleidomastoid muscle, at the angle of the lower jaw. The increase in these nodes is noticeable at a distance when the head is turned to the side. Sometimes lymph nodes look like a chain or a package and are often symmetrically located, their size (diameter) can reach 1-3 cm. They are elastic, moderately painful to the touch, not welded together, mobile, the skin above them is not changed. Edema of the subcutaneous tissue (lymphostasis) is possible, which spreads to the submandibular area, neck, sometimes up to the collarbones. At the same time, an increase in the axillary and inguinal lymph nodes is found. Less commonly, there is an increase in bronchopulmonary, mediastinal and mesenteric lymph nodes.
Due to the defeat of the pharyngeal tonsil, nasal congestion appears, difficulty in nasal breathing, and the voice changes. However, despite this, nasal discharge in the acute period of the disease is almost not observed because with infectious mononucleosis posterior rhinitis develops - the mucous membrane of the inferior turbinate, the entrance to the nasal part of the pharynx, is affected.
Simultaneously with adenopathy, symptoms of acute tonsillitis appear. Angina can be catarrhal, follicular, lacunar, ulcerative-necrotic, sometimes with the formation of a pearlescent white or creamy plaque in color, and in some cases - fibrinous films that resemble diphtheria. Plaque can spread outside the tonsils, with increased fever or recovery from a previous drop in body temperature. Cases of infectious mononucleosis without signs of angina have been described.
Enlargement of the liver and spleen is one of the persistent symptoms of infectious mononucleosis. In most patients, an increase in the spleen is detected already from the first days of the disease, it is of a relatively soft consistency, reaching its maximum size on the 4-10th day of the disease. Normalization of its size occurs not earlier than 2-3 weeks of illness, after normalization of the size of the liver. The liver also enlarges maximally on the 4-10th day of illness. In some cases (15%), an enlarged liver may be accompanied by a slight impairment of its function, moderate jaundice.
In 5-25% of patients with infectious mononucleosis, a rash appears, which can be spotty, maculopapular, urticarial, hemorrhagic. The timing of the appearance of the rash is different, it is contained for 1-3 days and disappears without a trace.
Changes in the blood of patients with infectious mononucleosis are characteristic. Leukopenia, which can manifest itself in the first 2 days of illness, is changed by leukocytosis - 10-25 | 109 in 1 l. The number of mononuclear cells (lymphocytes, monocytes) increases significantly (up to 50-80%); ESR-15-ZO mm / year. Most characteristic feature is the presence of atypical mononuclear cells (monocyte-like lymphocytes) - mature atypical mononuclear cells, ranging in size from an average lymphocyte to a large monocyte, which have a large spongy nucleus. The protoplasm of the cells is wide, basophilic, and contains delicate azurophilic granularity. Their number can reach 20% or more. Atypical mononuclear cells are found in 80-85% of patients. They appear on the 2-3rd day of illness and are observed in the blood for 3-4 weeks, sometimes up to 2 months or more.
Unified classification clinical forms there is no infectious mononucleosis. There are typical and atypical forms. Atypical forms include cases of the disease when there are only some typical symptoms (for example, polyadenitis) or the most significant signs that are not typical - exanthema, jaundice, symptoms of damage nervous system and others. There is an erased, asymptomatic course of the disease.
In 10-15% of cases, a relapse of the disease is possible (sometimes several), with a lighter course, with a shorter fever. Much less often there is a protracted course of the disease - more than 3 months.
Complications rarely develop. The occurrence of otitis media, paratonsilitis, pneumonia is possible, which is associated with the addition of bacterial flora. In some cases, there may be a rupture of the spleen, acute hemolytic anemia, meningoencephalitis, neuritis, polyradiculoneuritis, etc.

Prognosis of infectious mononucleosis

The disease usually ends with a complete recovery. Death is very rare.

Diagnosis of infectious mononucleosis

The main symptoms of the clinical diagnosis of infectious mononucleosis are fever, acute tonsillitis, polyadenitis, hepatosplenomegaly, lymphocytosis, monocytosis and the presence of atypical mononuclear cells in the blood. In doubtful cases, serological studies are used, which are various modifications of heterohemaglutination. Among them, the most common Paul-Bunnell reaction modified by Davidson, which allows detecting heterophilic antibodies against ram erythrocytes in the blood serum of patients with infectious mononucleosis (diagnostic titer 1: 32 and higher).
The simplest and most informative is the Goff-Bauer reaction with formalinized horse erythrocytes on a glass slide. To carry it out, only one drop of the patient's blood serum is needed. The answer is instantaneous. The reaction is positive in 90% of cases. A reaction of agglutination of trypsinized bovine erythrocytes with the patient's blood serum is also used, which is pretreated with an extract of the kidney of a guinea pig. In patients with infectious mononucleosis, this reaction is positive in 90% of cases. A reaction based on the ability of the blood serum of a patient with infectious mononucleosis to hemolysate bovine erythrocytes is also used. These reactions are nonspecific, some of them may be positive in other diseases, reducing their diagnostic information value.

Differential diagnosis of infectious mononucleosis

Infectious mononucleosis is differentiated from diphtheria, angina, lymphogranulomatosis, fellinosis, acute leukemia, listeriosis, viral hepatitis, AIDS.
Plaques on the tonsils with infectious mononucleosis often resemble diphtheria. However, diphtheria plaques are more dense, smooth surface, grayish-white.
With infectious mononucleosis, plaque is easily removed. Regional lymph nodes with diphtheria are slightly enlarged, there is no polyadnitis or enlargement of the spleen. On the part of the blood, neutrophilic leukocytosis is characteristic for diphtheria, and for infectious mononucleosis - lymphomonocytosis and the presence of atypical mononuclear cells.
With angina, unlike infectious mononucleosis, only regional lymph nodes increase, the spleen does not increase, neutrophilic leukocytosis is observed.
Lymphogranulomatosis has a long course with a wavy temperature curve, sweating, itching of the skin. Lymph nodes grow larger than in infectious mononucleosis, painless, elastic at first, and then dense. There are no changes in the peripheral blood that are typical for infectious mononucleosis, and eosinophilia is often detected during exacerbations. In doubtful cases, you need to carry out histological examinations punctate bone marrow, lymph nodes.
With fellinosis (benign lymphoreticulosis, cat scratch disease), lymphocygosis and the presence of atypical mononuclear cells in the blood are possible, but, unlike infectious mononucleosis, a primary affect is revealed, an isolated enlargement of lymph nodes, regional relative to the entrance gate of the infection, there is no angina and enlargement of other lymph nodes ...
In some cases of infectious mononucleosis with high leukocytosis (30-109 in 1 liter and above) and lymphocytosis (up to 90%), it should be differentiated from acute lymphocytic leukemia. The acyclic course of the disease, the progressive deterioration of the patient's condition, a sharp pallor of the skin, a decrease in the number of erythrocytes and hemoglobin, thrombocytopenia are the main manifestations of lymphocytic leukemia. The final diagnosis is based on the analysis of the punctate of the lymph node, sternum.
The anginal-septic form of listeriosis, like infectious mononucleosis, is characterized by significant intoxication, angina, an increase in regional lymph nodes, an increase in other groups of lymph nodes, liver, spleen, and the number of mononuclear cells in the blood is also possible. Therefore, it is difficult to differentiate these two diseases. However, if the patient has symptoms of purulent conjunctivitis, a runny nose with intense discharge, a polymorphic rash on the trunk, tonsillitis, meningeal symptoms, it is possible to suspect listeriosis.
If infectious mononucleosis is accompanied by jaundice, it must be differentiated from viral hepatitis. Patients with viral hepatitis usually do not have prolonged fever, polyadenitis, pronounced biochemical changes in the blood serum (increased activity of serum aminotransferases and other indicators), accelerated ESR, atypical mononuclear cells in the peripheral blood.
Sometimes it becomes necessary to differentiate infectious mononucleosis with AIDS, which is also characterized by swollen lymph nodes, fever. However, unlike infectious mononucleosis, AIDS occurs with prolonged lymphadenopathy due to an increase in two or more groups of lymph nodes, intermittent or persistent fever, diarrhea, weight loss, sweating, lethargy, skin lesions. Immunological studies of the blood of AIDS patients reveal a decrease in the number of T-helper lymphocytes, a decrease in the ratio of T-helpers to T-suppressors, an increase in the level of serum immunoglobulins, an increase in the number of immune complexes circulating.

Treatment of infectious mononucleosis

The specific therapy of infectious mononucleosis has not been developed, therefore, symptomatic, desensitizing, restorative treatment is carried out in practice. Antibiotics are used only in cases where the fever lasts longer than 6-7 days, the manifestations of angina are pronounced and accompanied by a significant increase in tonsillar lymph nodes.
For the treatment of patients with severe forms, glycocorticosteroids are used, the basis for the appointment of which is the morphological substrate of the disease (hyperplasia of lymphoid tissue). Detoxification is carried out. In all cases, gargling with solutions of rivanol, iodinol, furacilin and other antiseptic agents is required.

Prevention of infectious mononucleosis

The specific prevention of infectious mononucleosis has not been developed. Patients are hospitalized for clinical reasons: Quarantine is not established. Disinfection measures are not carried out in the focus of infection.
Mononucleosis is a pathology first described by the scientist Filatov back in 1885. Only in 1964 did it become clear that the nature of the disease is infectious and the methods of therapy began to improve. From this article you will learn everything about what mononucleosis is, what are the symptoms and treatment of this disease, what are the signs of the appearance of pathology and what are the reasons for its development.

What is mononucleosis

Acute infectious mononucleosis is a disease that affects the lymphoid tissue of the oropharynx and nasopharynx. In another way, the pathology was called glandular fever or monocytic angina due to the similarity of clinical symptoms. The causative agent of the disease is the Epstein-Barr virus. Soon after infection, the composition of peripheral blood changes and atypical mononuclear cells and heterophilic antibodies can be found in it.

Viral mononucleosis is diagnosed in both men and women. Although this infection is sometimes found in adults, it is more common in. After this virus has entered the body, a person develops lifelong immunity to it, although the infection itself remains for life. During the first 18 months after initial infection, viruses are released into the environment and others can become infected.

Note! Outbreaks of infections are more common in the fall months.

Features of the virus and its transmission route

The Epstein-Barr virus belongs to the group of herpes viruses. It has two DNA molecules and is distinguished by oncogenic and opportunistic properties.

The incubation period for this pathogen is 5-20 days. This infection is dangerous only for humans, animals do not get infected. You can only get the virus from another person who has an infection or is a carrier.

In another way, infectious mononucleosis is called kissing disease, since the pathogen is transmitted mainly through saliva. That is why outbreaks of the disease most often occur among adolescents: they eat and drink more from the same dish and kiss.

Other causes of the disease and the mechanisms of transmission of infection to other people can be distinguished:

• during blood transfusion;
• by airborne droplets;
• through common household items;
• while using shared toys among children;
• during sexual intercourse;
• due to the use of shared toothbrushes;
• through the placenta;
• when transplanting organs from a sick person to a healthy one.

Up to 50% of the adult population of the world at some point in their lives suffered from this infection. The peak incidence among adolescent girls is at 14-16 years old, and among boys at 16-18 years old. In a child, dirty hands and unscrupulous hygiene become the cause of the development of the disease. After 40 years, this diagnosis is extremely rare. For patients with immunodeficiencies, the risk of infection remains, regardless of age.

Important! During normal conversation next to a sick person or carrier of infection, the probability of infection is extremely small, but during sneezing, coughing or close contact, the risk increases.

Although a large percentage of the world's population is carriers of the infection, complaints that arise with infectious mononucleosis are quite rare.

Classification of the disease

There is no specific classification of infectious mononucleosis. Allocate different types currents, namely:

• lung;
• the average;
• heavy course.

The form in which mononucleosis will proceed depends on the state of human health, the immune system and the presence of concomitant diseases.

To determine the disease, it is important to be attentive to your body and detect the first signs of infection in time. After the pathogen has entered the body, it begins to actively divide. From the oral cavity, genital tract or intestines, where it got immediately, it enters the bloodstream and is introduced into lymphocytes. These blood cells will forever carry the infection.

During the first few days, initial stage diseases for which the following symptoms are characteristic:

• general weakness in the body;
• muscle pain;
• nausea;
• headache;
• fever;
• chills;
• decreased appetite.

This is followed by the next stage of the disease, which in some patients occurs within a few days after the onset of the disease, and in others only after 2 weeks. Symptoms include three main signs:

• temperature rise;
• change in the state of the lymph nodes;
• sore throat.

Note! Angina is different from mononucleosis, but an experienced doctor will probably be able to notice the differences.

Mononucleosis is extremely rare without temperature. Of all cases of the disease, this indicator does not increase only in 10% of cases. For most, the temperature remains within 38 degrees. Less often, it reaches up to 40 degrees. Even after the peak of the disease has passed, sometimes the fever persists for several months. Patients do not suffer from severe chills or excessive sweating during attacks of fever.

Lymph nodes undergo significant changes. First, the cervical lymph nodes are affected (polylymphadenopathy), then the axillary and inguinal. Less often, the internal intestinal lymph nodes and bronchial ones are involved in the pathological process. They undergo the following changes:

• become painful on palpation;
• too dense;
• increase in size;
• become mobile.

Important! If the peritoneal or bronchial lymph nodes are affected, coughing and abdominal pain on the right may occur.

A sore throat is accompanied by visible changes. A photo of the throat can be seen below. The following changes are obvious:

• the back wall is prone to hyperemia;
• swelling is observed;
• the tonsils are enlarged;
• they are covered with an easily removable plaque.

Problems can also affect vital internal organs... So, soon after the pathogen of the Epstein-Barr virus enters the body, the liver and spleen increase. The doctor should be able to immediately differentiate mononucleosis from other pathologies, since some patients experience yellowness of the sclera of the eyes, and sometimes of the skin.

Important! By the 5-10th day of the disease, the spleen reaches its maximum size and in case of accidental injury, the risk of rupture is high, which entails unpleasant consequences. Therefore, patients are shown complete rest.

The normalization of the size of the liver and spleen occurs several days after the temperature has returned to normal. During this period, the likelihood of exacerbation decreases.

With mononucleous angina, there is often a rash. It can be spread over the skin, and sometimes localized to the soft palate. This symptom can appear and disappear repeatedly during the entire illness.

All these types of symptoms will not mislead an experienced doctor, although it may seem that in children it is a frequent occurrence and the diagnosis should be just that. Thanks to modern methods diagnostics, doctor's assumptions can be confirmed or refuted. In infectious mononucleosis, atypical mononuclear cells in the general blood count are increased.

In order to cure the disease, it takes at least 2 weeks. If it was not possible to get rid of the pathology during this period, there is a risk of complications. It is extremely rare to treat mononucleosis within 2-3 months. This is usually due to the fact that the disease was noticed very late, and first aid was not provided.

Note! It is believed that conjunctivitis and mononucleosis are incompatible diseases, but this has not been proven.

When correct therapy, especially in childhood, chronic mononucleosis does not develop. Relapses also do not happen, as the body produces antibodies that remain in the blood for life.

Possible complications

If you do not start adequate therapy medical methods, and to carry out treatment with folk remedies, the risk of complications is high:

The restoration of the body is possible if a thorough diagnosis is carried out in a timely manner and drugs are selected for the treatment of pathology.

Diagnostic measures

It is important to get the right blood tests and tests to get the right medication and not treat a false sore throat. The blood picture changes as follows:

• there is plasmatization of the cytoplasm of lymphocytes, that is, a violation of the structure of these cells;
• the appearance of wide-plasma lymphocytes;
• the norm of mononuclear cells in the acute period of the disease is from 5-50%, depending on the intensity of the pathology.

Note! If more than 10% of atypical lymphocytes are found in a blood test, the diagnosis is considered confirmed.

Decoding the results laboratory research carried out only by a specialist. It makes sense to conduct a blood test for antibodies to the Epstein-Barr virus. In the presence of class M immunoglobulin titers, it indicates an acute process. In the presence of IgG, they speak of a previous illness. Sometimes PCR analysis is performed to identify the DNA of the pathogen.

Additional diagnostic methods can be carried out only in order to determine how much the internal organs have suffered and to exclude other pathologies.

Treatment principles

If mononucleosis is mild or moderate, home treatment is performed. The patient must strictly follow the recommendations from the doctor's prescription and adhere to quarantine. Application folk ways therapy is permissible, but only in agreement with the doctor and as an auxiliary therapy.

If inflammation of the liver has joined the pathological process, the patient should follow diet No. 5. At the same time, nutrition should be complete so that the body receives all the necessary nutrients during illness.

Specific drugthat is used against the Epstein-Barr virus does not exist. Therefore, appointed antiviral drugs general action:

It is important to take into account that each drug has contraindications and side effects, which should be familiarized with before starting treatment. You should be especially careful during pregnancy, as many medications can cause irreparable harm to the fetus.

Note! When the temperature rises above 38.5 degrees, it is necessary to take an antipyretic agent.

In severe cases and in the case of a bacterial infection, the use of antibiotics is recommended:

To stimulate the outflow of lymph and restore the full functions of the lymphatic system, the doctor may prescribe the drug "Lymphomyosot". Sometimes hormones, antihistamines and antiseptics are prescribed.

Prevention

There is no specific prophylaxis. A vaccine for inoculation is still under development and is not widely used.

The best protection against infectious diseases is careful hygiene, maintaining good immunity and avoiding contact with people suffering from fever.

Watch the video:

• Prevention of Infectious Mononucleosis
• Which doctors should I contact if you have Infectious mononucleosis

What is Infectious Mononucleosis

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

The 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; Taydi 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 Infectious mononucleosis

The causative agent of infectious mononucleosis- DNA genomic virus of the genus Lymphocryptovirus of the Gammaherpesvirinae subfamily of the Herpesviridae family. The virus is able to replicate, including in B-lymphocytes; unlike other herpes viruses, it does not cause cell death, but, on the contrary, activates their proliferation. Virions include specific antigens: capsid (VCA), nuclear (EBNA), early (EA) and membrane (MA) antigens. Each of them is formed in a specific 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 it dries, under the influence of high temperature and disinfectants.

Infectious mononucleosis is just 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 is poorly understood.

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 persons shed the virus from the last days of incubation and for 6-18 months after the primary 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 suffered an infection and have excreted the pathogen with saliva for a long time.

Transmission mechanism - aerosol, transmission route - airborne. Very often the virus is excreted in saliva, so infection by contact is possible (with kissing, sexually, through hands, toys and household items). Transmission of infection is possible through blood transfusions, as well as during childbirth.

Natural susceptibility of people high, however, dominated by lungs and erased forms disease. 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 the infection.

Main epidemiological signs. The disease is widespread; mostly sporadic cases, sometimes small outbreaks. The polymorphism of the clinical picture, the rather frequent difficulties in diagnosing the disease suggest that the level of officially registered morbidity in Ukraine does not reflect the true breadth of the spread of infection. Most often adolescents get sick, in girls the maximum incidence is recorded at 14-16 years old, in boys - at 16-18 years old. Therefore, infectious mononucleosis is sometimes also called "student disease". Persons over 40 years of age rarely get sick, but in HIV-infected people, latent infection can be reactivated at any age. When infected in early childhood, the primary infection proceeds in the form of a respiratory disease, at older ages it is asymptomatic. By the age of 30-35, antibodies to the virus of infectious mononucleosis are detected in the blood of most people, therefore, clinically expressed forms are rarely found among adults. Diseases are recorded throughout the year, somewhat less often in the summer months. Crowding, the use of common linen, dishes, and close household contacts contribute to the infection.

Pathogenesis (What Happens?) During Infectious Mononucleosis

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

The replication of the virus in B-lymphocytes stimulates their active proliferation and differentiation into plasma cells. The latter secrete immunoglobulins of low specificity. At the same time, in the acute period of the disease, 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 by recognizing membrane virus-induced antigens. However, the virus remains in the body and persists in it throughout subsequent life, causing the chronic course of the disease with reactivation of the infection with a decrease in immunity.

The severity of immunological reactions in infectious mononucleosis makes it possible 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 is possible without specific symptoms... In these cases, the disease develops gradually: for several days, subfebrile body temperature, malaise, weakness, increased fatigue, catarrhal phenomena in the upper respiratory tract - nasal congestion, hyperemia of the mucous membrane of the oropharynx, enlargement and hyperemia of the tonsils are observed.

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

By the end of the first week of the disease, the height of the disease develops. The appearance of all major clinical syndromes: general toxic phenomena, tonsillitis, lymphadenopathy, hepatolienal syndrome. The patient's state of health worsens, note high temperature body, chills, headache and body aches. There may be nasal congestion with difficulty in nasal breathing, nasal voice. Lesions of the throat are manifested by an increase in sore throat, development of angina in catarrhal, necrotic ulcerative, follicular or membranous form. Hyperemia of the mucous membrane is not sharply expressed, friable yellowish easily removable plaques appear on the tonsils. In some cases, plaque can resemble diphtheria. On the mucous membrane of the soft palate, hemorrhagic elements may appear, the posterior wall of the pharynx is sharply hyperemic, loosened, granular, with hyperplastic follicles.

From the very first days it develops lymphadenopathy... Enlarged lymph nodes can be found in all areas accessible to palpation; the symmetry of their defeat is characteristic. Most often, with mononucleosis, the occipital, submandibular and especially the posterior cervical lymph nodes increase on both sides along the course of the sternocleidomastoid muscles. Lymph nodes are compacted, mobile, painless or slightly painful on palpation. Their sizes range from a pea to a walnut. The subcutaneous tissue around the lymph nodes may in some cases 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: dyspeptic symptoms (decreased appetite, nausea) intensify, urine darkens, sclera and skin become icterus, serum bilirubin increases and the activity of aminotransferases increases.

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

Following the period of the peak of the disease, lasting on average 2-3 weeks, 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 last for a long time, with a change in periods of exacerbations and remissions, because of which its total duration can be delayed up to 1.5 years.

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

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

Diagnosis of Infectious Mononucleosis

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

Laboratory diagnostics of infectious mononucleosis
The most characteristic feature is changes in the cellular composition of the blood. The hemogram reveals moderate leukocytosis, relative neutropenia with a shift leukocyte formula to the left, a significant increase in the number of lymphocytes and monocytes (more than 60% in total). The blood contains atypical mononuclear cells - cells with a wide basophilic cytoplasm, having a different shape. Their presence in the blood has determined the modern name of the disease. An increase in the number of atypical mononuclear cells with a wide cytoplasm is of diagnostic value to 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 alleged diagnosis, since their appearance in the peripheral blood can 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 can detect viral DNA 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 during the 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 transferred disease, IgG to VCA antigens are preserved for life.

In the absence of the possibility of detecting 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 sheep erythrocytes (diagnostic titer 1:32) and the more sensitive Hoff-Bauer reaction with horse erythrocytes. Insufficient specificity of the reactions reduces their diagnostic value.

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

Treatment of Infectious Mononucleosis

Patients with mild and moderate infectious mononucleosis can be treated at home. The need for bed rest is determined by the severity of intoxication. In cases of illness with manifestations of hepatitis, a diet is recommended (table number 5).

No specific therapy has been developed. They carry out detoxification therapy, desensitizing, symptomatic and restorative treatment, rinsing the oropharynx with antiseptic solutions. Antibiotics are not prescribed in the absence of bacterial complications. With a hypertoxic course of the disease, as well as with the threat of asphyxia caused by edema of the pharynx and a pronounced increase in the tonsils, a short course of treatment with glucocorticoids is prescribed (prednisolone orally at a daily dose of 1-1.5 mg / kg for 3-4 days).

On October 12, 13 and 14, Russia is hosting a large-scale social action on free blood clotting test - “INR Day”. The action is timed to coincide with the World Thrombosis Day.

07.05.2019

The incidence of meningococcal disease in the Russian Federation in 2018 (compared to 2017) increased by 10% (1). One of the most common methods of prevention infectious diseases - vaccination. Modern conjugate vaccines are aimed at preventing the occurrence of meningococcal infection and meningococcal meningitis in children (even the very young), adolescents and adults.

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