Symptoms and methods of treatment of infectious mononucleosis in children. Symptoms of mononucleosis in children and treatment according to Komarovsky What is mononucleosis in children and how

Mononucleosis is an infectious disease similar in symptoms to the flu or a sore throat, but also affects the internal organs. One of the characteristic manifestations of this ailment is the enlargement of the lymph glands in various parts of the body, which is why it is known as "glandular fever". Mononucleosis also has an unofficial name: "kissing disease" - the infection is easily transmitted through saliva. Particular attention should be paid to the treatment of complications that distinguish this disease from the common cold. An important role is played by dietary immunostimulating nutrition.

Content:

Causative agents and forms of infectious mononucleosis

The causative agents of mononucleosis are herpesviruses of various types. Most often, it is the Epstein-Barr virus, named after the scientists who discovered it, Michael Epstein and Yvonne Barr. There is also infectious mononucleosis of cytomegalovirus origin. In rare cases, other types of herpes viruses can be the causative agents. The manifestations of the disease do not depend on their type.

Course of the disease

It occurs mainly in young children and adolescents. As a rule, every adult person had this disease in childhood.

The virus begins to develop in the mucous membrane oral cavity, affecting the tonsils and pharynx. Through the blood and lymph, it enters the liver, spleen, heart muscles, and lymph nodes. The disease usually occurs in acute form. Complications occur extremely rarely - in the case when, as a result of weakened immunity, secondary pathogenic microflora is activated. This is manifested by inflammatory diseases of the lungs (pneumonia), middle ear, maxillary sinuses and other organs.

The incubation period can range from 5 days to 2-3 weeks. The acute stage of the disease usually lasts 2-4 weeks. With a large number of viruses and untimely treatment, mononucleosis can turn into chronic form, in which the lymph nodes are constantly enlarged, damage to the heart, brain, and nerve centers is possible. In this case, the child develops psychosis, facial expression disorders.

After recovery, the viruses that cause infectious mononucleosis remain forever in the body, so the recovered person is its carrier and source of infection. However, the re-infection of the person himself is extremely rare, in the event that for some reason he has a sharp weakening of immunity.

Note: It is precisely because the virus carrier in mononucleosis remains for life that it makes no sense to isolate the child from other people after he has signs of malaise. Healthy people can protect themselves from infection only by strengthening the immune forces.

Forms of the disease

There are the following forms:

1. Typical - with pronounced symptoms, such as fever, tonsillitis, enlargement of the liver and spleen, the presence of virocytes in the blood (the so-called atypical mononuclear cells - a type of leukocyte).
2. Atypical. In this form of the disease, any of characteristic symptoms infectious mononucleosis in a child is completely absent (for example, virocytes are not found in the blood) or the symptoms are implicit, erased. Sometimes there are pronounced lesions of the heart, nervous system, lungs, kidneys (the so-called visceral organ damage).

Depending on the severity of the course of the disease, enlargement of the lymph nodes, liver and spleen, the number of mononuclear cells in the blood, typical mononucleosis is divided into mild, moderate and severe.

There are the following forms of the course of mononucleosis:

• smooth;
• uncomplicated;
• complicated;
• protracted.

Video: Features of infectious mononucleosis. Dr. E. Komarovsky answers questions from parents

Causes and ways of infection with infectious mononucleosis

The cause of infection of children with infectious mononucleosis is close contact with a sick person, or a virus carrier. In the environment, the pathogen quickly dies. You can get infected with a kiss (a common cause of infection in adolescents), when using the same dish with a sick person. Children play in the children's group shared toys, often confuse their water bottle or pacifier with someone else's. The virus can be on a towel, bed linen, clothes of the patient. When sneezing and coughing, the causative agents of mononucleosis enter the surrounding air with droplets of saliva.

Children of preschool and school age are in close contact, so they get sick more often. In infants, infectious mononucleosis occurs much less frequently. There may be cases of intrauterine infection of the fetus through the mother's blood. It is noticed that boys suffer from mononucleosis more often than girls.

The peak incidence of children occurs in spring and autumn (outbreaks are possible in a children's institution), since weakened immunity and hypothermia contribute to the infection and spread of viruses.

A warning: Mononucleosis is a highly contagious disease. If the child was in contact with the patient, then within 2-3 months, parents should pay special attention to any indisposition of the baby. If there are no obvious symptoms, this means that the body's immune system is strong enough. The disease could be mild or infection could be avoided.

Symptoms and signs of the disease

The most characteristic signs of infectious mononucleosis in children are:

1. Sore throat when swallowing due to inflammation of the pharynx and abnormal growth of the tonsils. A raid appears on them. At the same time, it smells bad from the mouth.
2. Difficulty in nasal breathing due to damage to the nasal mucosa and the occurrence of edema. The child snores and cannot breathe with his mouth closed. There is a runny nose.
3. Manifestations of general intoxication of the body with the products of the vital activity of the virus. These include aching muscles and bones, a feverish condition in which the baby's temperature rises to 38 ° -39 °, chills are observed. The baby is sweating a lot. There is a headache, general weakness.
4. The emergence of "chronic fatigue syndrome", which manifests itself several months after the illness.
5. inflammation and enlargement lymph nodes on the neck, groin and armpits. If there is an increase in the lymph nodes in the abdominal cavity, then due to the compression of the nerve endings, severe pain occurs (“acute abdomen”), which can mislead the doctor when making a diagnosis.
6. Enlargement of the liver and spleen, the occurrence of jaundice, dark urine. With a strong increase in the spleen, even its rupture occurs.
7. The appearance of a small pink rash on the skin of the hands, face, back and abdomen. In this case, itching is not observed. The rash disappears on its own after a few days. If an itchy rash appears, it indicates an allergic reaction to a drug (usually an antibiotic).
8. Signs of disruption of the central nervous system: dizziness, insomnia.
9. Swelling of the face, especially of the eyelids.

The child becomes lethargic, tends to lie down, refuses to eat. There may be symptoms of a violation of the heart (palpitations, murmurs). After adequate treatment, all these signs disappear without consequences.

Note: As Dr. E. Komarovsky emphasizes, infectious mononucleosis differs from tonsillitis, first of all, in that, in addition to a sore throat, nasal congestion and a runny nose occur. The second distinguishing feature is the enlargement of the spleen and liver. The third sign is an increased content of mononuclear cells in the blood, which is established using a laboratory analysis.

Often in young children, the symptoms of mononucleosis are mild, they can not always be distinguished from the symptoms of SARS. In babies of the first year of life, mononucleosis gives a runny nose, cough. When breathing, wheezing is heard, redness of the throat and inflammation of the tonsils occur. At this age, a rash on the skin appears more often than in older children.

Before the age of 3 years, it is more difficult to diagnose mononucleosis by blood tests, since it is not always possible to obtain reliable results of antigen reactions in a small child.

The most pronounced signs of mononucleosis appear in children aged 6 to 15 years. If only fever is observed, this indicates that the body is successfully fighting the infection. Fatigue syndrome persists for 4 months after the disappearance of other signs of the disease.

Video: Symptoms of infectious mononucleosis

Diagnosis of infectious mononucleosis in children

To distinguish infectious mononucleosis from other diseases and prescribe proper treatment, diagnostics is carried out using various laboratory methods. The following blood tests are performed:

1. General - to determine the content of such components as leukocytes, lymphocytes, monocytes, as well as ESR (erythrocyte sedimentation rate). All these indicators in children are increased by about 1.5 times with mononucleosis. Atypical mononuclear cells do not appear immediately, but after a few days and even 2-3 weeks after infection.
2. Biochemical - to determine the content of glucose, protein, urea and other substances in the blood. These indicators evaluate the work of the liver, kidneys and other internal organs.
3. Enzyme immunoassay (ELISA) for antibodies to herpes viruses.
4. PCR analysis for fast and accurate identification of viruses by DNA.

Since mononuclear cells are found in the blood of children and with some other diseases (for example, with HIV), tests are carried out for antibodies to other types of infection. To determine the condition of the liver, spleen and other organs, ultrasound is prescribed for children before treatment.

Treatment of mononucleosis

There are no drugs that destroy the viral infection, so children with mononucleosis are treated to relieve symptoms and prevent the development of serious complications. The patient is prescribed bed rest at home. Hospitalization is carried out only if the disease is severe, complicated high temperature, repeated vomiting, damage to the respiratory tract (creating the risk of suffocation), as well as disruption of the internal organs.

Medical treatment

Antibiotics do not act on viruses, so their use is useless, and in some babies they cause allergic reaction. Such drugs (azithromycin, clarithromycin) are prescribed only in case of complications due to the activation of a bacterial infection. At the same time, probiotics are prescribed to restore beneficial intestinal microflora (acipol).

In the treatment, antipyretics are used (panadol, ibuprofen syrups for babies). To relieve inflammation of the throat, rinses with a solution of soda, furacilin, as well as infusions of chamomile, calendula and other medicinal herbs are used.

Relief of symptoms of intoxication, elimination of allergic reactions to toxins, prevention of bronchospasm (when the virus spreads to the respiratory organs) is achieved with the help of antihistamines(Zirtek, Claritin in the form of drops or tablets).

To restore the functioning of the liver, choleretic agents and hepatoprotectors (Essentiale, Karsil) are prescribed.

Immunomodulatory and antiviral drugs, such as imudon, cycloferon, anaferon, are used in children to strengthen immunity. The dose of the drug is calculated depending on the age and weight of the patient. Of great importance during the period of treatment is vitamin therapy, as well as adherence to a therapeutic diet.

With severe swelling of the larynx, apply hormonal preparations(prednisolone, for example), and if normal breathing is impossible, artificial ventilation of the lungs is performed.

When the spleen ruptures, it is removed surgically (splenectomy is performed).

A warning: It must be remembered that any treatment for this disease should be carried out only as directed by a doctor. Self-medication will lead to severe and irreparable complications.

Video: Treatment of infectious mononucleosis in children

Prevention of complications of mononucleosis

In order to prevent the development of complications in mononucleosis, the child's condition is monitored not only during the illness, but also within 1 year after the disappearance of manifestations. The composition of the blood, the condition of the liver, lungs and other organs are monitored in order to prevent leukemia (bone marrow damage), inflammation of the liver, and disruption of the respiratory system.

It is considered normal if, with infectious mononucleosis, angina continues for 1-2 weeks, the lymph nodes are enlarged for 1 month, drowsiness and fatigue are observed up to six months from the onset of the disease. The temperature is 37°-39° for the first few weeks.

Diet for mononucleosis

With this disease, food should be fortified, liquid, high-calorie, but low-fat, so that the work of the liver is maximally facilitated. The diet includes soups, cereals, dairy products, boiled lean meat and fish, as well as sweet fruits. It is forbidden to eat spicy, salty and sour foods, garlic and onions.

The patient should consume a lot of fluids (herbal teas, compotes) so that dehydration does not occur, and toxins are excreted in the urine as soon as possible.

The use of traditional medicine for the treatment of mononucleosis

Such funds, with the knowledge of the doctor, after an appropriate examination, are used to alleviate the condition of a child with mononucleosis.

To eliminate fever, it is recommended to drink decoctions of chamomile, mint, dill, as well as teas from raspberry, currant, maple leaves, adding honey and lemon juice. Linden tea, lingonberry juice helps relieve headaches and body aches caused by intoxication of the body.

To alleviate the condition and speed up recovery, decoctions from herbal preparations are used, for example, from a mixture of rosehips, mint, motherwort, oregano and yarrow, as well as infusions from the fruits of mountain ash, hawthorn with the addition of birch leaves, blackberries, lingonberries, currants.

Echinacea tea (leaves, flowers or roots) helps to fight germs and viruses, strengthen the immune system. For 0.5 liters of boiling water, 2 tbsp. l. raw materials and infused for 40 minutes. Give the patient 3 glasses a day in the acute period. You can drink such tea and for the prevention of the disease (1 glass a day).

Melissa grass has a strong soothing, anti-allergenic, immunomodulatory, antioxidant effect, from which medicinal tea is also prepared, they drink it with honey (2-3 cups a day).

On swollen lymph nodes, you can apply compresses with an infusion prepared from birch leaves, willow, currant, pine buds, calendula flowers, chamomile. Brew 1 liter of boiling water 5 tbsp. l. mixtures of dried ingredients, insist for 20 minutes. Compresses are applied for 15-20 minutes every other day.

The article describes the disease - mononucleosis in children, symptoms and treatment, diagnosis, prevention and recommendations for patients during the treatment of the disease.

What is infectious mononucleosis?

Mononucleosis is an infectious viral disease that resembles a common respiratory infection in its manifestations, but at the same time its course affects the state of internal organs. A characteristic sign of mononucleosis is the enlargement of the lymphatic glands of the body, especially the spleen. The disease also negatively affects the state of the respiratory system and liver.

The causative agent of mononucleosis is the Epstein-Barr virus, which mainly affects lymphatic system organism.

The main risk group for this disease is boys of childhood and adolescence.

Adults rarely suffer from this disease. The disease has a short history, its causative agent was discovered relatively recently, so to this day the treatment is mainly symptomatic.

❗However, knowing the symptoms also does not always guarantee timely detection of the disease. There are frequent cases of atypical mononucleosis, when the symptoms are greatly smoothed or completely erased, and the disease is diagnosed by chance in the course of other studies. Mononucleosis, on the other hand, can manifest itself excessively.

Mononucleosis spreads mainly from person to person in everyday situations: eating from shared dishes, sneezing, coughing, kissing.

☝ Infectiousness greatly increases in institutions of a closed and semi-closed type - schools, kindergartens, sections, etc. Given that the disease most often affects children under 10 years of age, these places become the main source of the epidemic.

As already mentioned, in a considerable number of cases, the disease does not manifest itself in any way, but the person carrying the virus is still contagious to others. More than half of all patients experience only symptoms similar to the common cold, while statistical analysis of medical data suggests that up to 90% of adults are infected with the virus.

Infectious mononucleosis in an erased form

Ignoring the symptoms of mononucleosis and refusing timely treatment can lead to serious consequences that can even lead to disability or death. The specificity of the disease lies in the fact that no medicine has been developed against it, aimed at combating a specific pathogen, and all treatment comes down to maintaining the natural forces of the body and its immune system.

Symptoms of infectious mononucleosis

In most cases, it is impossible to say exactly from whom the virus was transmitted to a particular patient. The source of infection may feel completely healthy and not suspect that he is a carrier. In the meantime, you can get infected from it even with a normal conversation, or drinking tea from one cup.☹

The incubation period of the disease lasts from 5 to 15 days. Sometimes, with a combination of some factors of the characteristics of the patient's body, the incubation period can stretch up to one and a half months. Only then do they appear Clinical signs. As a rule, for such a period it is impossible to remember exactly with whom the child had potentially dangerous contact.

❗If parents know for sure that the baby has been in contact with an infected person, careful monitoring of his condition is required for a couple of months. If during this time characteristic feature does not appear, which means that the immune system coped with the disease.

Often the disease begins with a general intoxication, typical of any other viral disease - for example, influenza. The patient feels chills, weakness, rise in temperature. Characteristic are skin rashes and palpable lymph nodes. Such manifestations are a reason to immediately contact a pediatrician.

Symptoms of mononucleosis can be very diverse. Most often, the temperature rises quite quickly to subfebrile indicators, a constant sore throat begins, difficulties with breathing and swallowing - this is an indicator of an increase in the tonsils. Visually, the throat is red, swollen, the nose is also blocked due to swelling of the mucosa.

The fever can last from a few days to a month. The temperature can rise to quite high levels. This is very debilitating for the child. The duration of the manifestation of a symptom depends on the individual state of the body, in particular the immune system, as well as the effectiveness of the treatment.

In the first week (sometimes longer) the child is constantly shivering, the nature of weakness and drowsiness, headache, pain when swallowing and a feeling of aching muscles. At the same stage, at the beginning of the disease, a rash appears, which can be quite intense and spread throughout the face and body. It does not itch, does not cause any discomfort, does not require separate treatment - the rashes go away on their own in the treatment of the underlying disease.

The most important symptom of the disease is an increase in lymph nodes.

They can change on any part of the body, are easily palpated, while the patient experiences pain. Polyadenitis occurs in the throat on the tonsils - deposits of a gray or white-yellow hue, which are easily removed, but are a sign of hyperplasia of the lymphoid tissue.

➡As already mentioned, mononucleosis also affects the endocrine glands. In particular, an enlarged spleen can lead to misdiagnosis and unnecessary surgery.

Diagnosis of the disease

As noted earlier, symptoms can vary in both manifestations and severity, so a pediatrician or infectious disease specialist should focus not only on external manifestations, but also on laboratory parameters to make a diagnosis. First of all, a reliable diagnostic method is a hemotest, or a blood test - general, biochemical and specific antibodies.

With mononucleosis, a pathological shift will be traced in the general blood formula, mainly a huge number of leukocytes due to the increased work of the lymph nodes. Also pathologically increased is the value of ESR - the erythrocyte sedimentation rate. It is also likely that atypical mononuclear cells appear in the blood formula - cells with an atypical structure, characterized by a large basophilic cytoplasm. The last sign is not on initial stage disease, and 2-3 weeks after its development.

➡The test for specific antibodies allows laboratory differential diagnosis with other diseases. This analysis is especially important in the atypical course of the disease. The analysis is carried out for IgM, IgG (immunoglobulins) and antibodies to the Epstein-Barr virus. Another option is PCR analysis, which also allows you to identify the exact type of infectious agent.

In addition, it is necessary to conduct an ultrasound of the abdominal organs, especially paying attention to the condition of the liver and spleen. This will help to assess their condition and choose a symptomatic treatment that will preserve the functionality of these organs, avoiding surgical intervention.

The PCR method is one of the most accurate

✔ In addition, it is necessary to re-pass serological tests within several months, which will allow us to differentiate laboratory indicators of mononucleosis from HIV infection (these conditions have a similar picture in a blood test).

Treatment of mononucleosis in children

Mononucleosis is a viral disease, so the use of antibiotics against it is pointless. There is no single medicine for the treatment of mononucleosis; various antiviral agents are used in therapy (Acyclovir, Isoprinosine, etc.). However, the main forces to fight the virus come from the body's natural immunity, and the higher it is initially, the more chances for a quick recovery without complications.

☝☝☝Children's doctor Komarovsky says that acute mononucleosis is a disease that in most cases is treated on an outpatient basis, i.e. at home with regular visits to the doctor.

However, in severe cases (especially for infants), hospitalization of the child in the hospital is indicated. The admission criteria are as follows:

• The temperature is above 39.5 C;
• Development of complications;
• Pronounced signs of intoxication of the body - vomiting, nausea, prolonged fever, etc.;
• Severe breathing difficulties, threat of suffocation.

There are various ways to treat mononucleosis. As mentioned earlier, the first method of therapy is symptomatic, designed to eliminate the manifestations of the disease, while the body's immunity fights the virus on its own. The drugs used for this purpose are mainly antipyretic drugs.

In the event that mononucleosis gives a complication in the form of a sore throat, local antiseptics are used, and immunomodulatory non-specific drugs are also prescribed to maintain the body's defenses. Antibiotics orally or by injection are prescribed only if a bacterial infection is attached and it is detected in the tests.

Often, the treatment of mononucleosis is accompanied by the appointment of fortifying vitamin agents, because. the body loses many useful substances during the fight against the disease. Hepatoprotectors and other drugs are also used to improve liver function. To avoid allergic reactions in response to a decrease in immunity, antihistamines are prescribed.

In the case of a severe course of the disease with clear signs of toxicosis, a short-term course of prednisolone is prescribed in a hospital. The drug is also used for high risk asphyxia. Also, with swelling of the larynx and severe breathing difficulties, a tracheostomy is installed, and the child is transferred to artificial ventilation.

Other dangerous complication mononucleosis is a rupture of the spleen. To avoid this, ultrasound monitoring of the state of the organ is regularly carried out, and in case of a rupture, a surgical operation is necessary.

☝You can often meet people who recommend treating mononucleosis with homeopathy. Including you can meet people who give positive feedback about such treatment. The popular rumor about the benefits of homeopathy is explained by the fact that the remedies themselves do not make the body either better or worse, and mononucleosis is sometimes cured on its own, provided that the child has strong immunity.

However, with such treatment, a complication can easily develop, which in turn threatens with consequences up to death.

As noted above, mononucleosis causes dysfunction of the liver and spleen. Therefore, during the treatment period, it is important to follow nutritional recommendations and follow a therapeutic diet. It is recommended to exclude the following foods from the diet:

• Sweet soda;
• Hot sauces, ketchup, mayonnaise;
• Coffee, cocoa, chocolate;
• Meat broths;
• Fatty meat dishes;
• Spicy dishes, seasonings, canned and pickled foods.

It is preferable that the diet is varied and the portions are small. It is advisable to eat boiled dietary meat, cereals, broths on poultry or vegetables. It is important that the child consumes a lot of liquid - it can be both ordinary water and compotes, fruit decoctions, juices diluted in a small concentration.

It is advisable to give the patient sweet fruits, cereals, dairy and sour-milk products, fish, rabbit, chicken. It is better if the food is crushed or served in a semi-liquid state. As a drink, warm weakly brewed tea or herbal decoctions are also suitable.

In the first days of acute onset of symptoms, the child may not have an appetite at all. In this case, you should not force-feed him, it is only important to ensure that he drinks enough fluids, especially if fever and vomiting are present in the symptoms.

⚠Children are easily dehydrated, and fluid imbalance negatively affects the course of the disease.

Possible complications and prevention of the disease

First of all, mononucleosis can cause complications in the work of those organs on which it has the greatest negative effect - the liver and spleen. With a prolonged or severe course of the disease, the patient may develop hepatitis, liver failure (especially in the case of a previous pathology), and the spleen may rupture due to excessive enlargement. In order to avoid these consequences, with a significant severity of symptoms, it is desirable to carry out treatment in a hospital, under the supervision of doctors.

In addition, with reduced immunity, mononucleosis can cause complications in the form of meningoencephalitis, bleeding, and chronic tonsillitis. In addition, it should be borne in mind that immunity to mononucleosis is not formed, i.e. she cannot get sick again, tk. the virus remains in the human body for life, being in an inactive form. However, in this case, the patient acts as a carrier and can infect others.

There is no cure for mononucleosis as such.

When registering an outbreak, patients should be isolated from being in groups (especially if it is preschool institutions), because the disease can be transmitted by contact-household. All other recommendations relate to maintaining the normal state of the immune system - regular exercise, exposure to fresh air, a healthy diet and timely treatment of infections.

An important step in maintaining immunity is the competent alternation of sleep and wakefulness and sufficient duration. This is especially true for schoolchildren and students. It has been proven that lack of sleep, like a fragmented regimen, reduces the body's natural defenses.

In a word, there is no universal vaccine or medicine that can protect a child from mononucleosis, however, with the right attitude to one's health, natural defense mechanisms will help to avoid infection, or transfer it with minimal risk of complications.

Infographics - symptoms, diagnosis, treatment

Infectious mononucleosis is one of the most common viral infections on earth: according to statistics, 80-90% of adults have antibodies to the pathogen in their blood.

It is the Epstein-Barr virus, named after the names of the virologists who discovered it in 1964. Children, adolescents and young adults are most susceptible to mononucleosis. In persons over 40 years of age, it develops extremely rarely, since before this age a strong immunity is formed as a result of an infection.

The virus is especially dangerous for people over 25 years of age, pregnant women (subject to primary infection), as it causes a severe course of the disease, the addition of a bacterial infection can cause miscarriage or stillbirth. Timely diagnosis and competent treatment significantly reduce the risk of developing such consequences.

What it is?

Infectious mononucleosis is an acute pathology of infectious genesis and anthroponotic profile, the course of which is accompanied by the appearance of a febrile reaction, damage to the oropharynx and organs of the reticuloendothelial system, as well as a provoking violation of the quantitative and qualitative composition of the blood.

History

On the infectious nature this disease was indicated by N. F. Filatov in 1887, who was the first to pay attention to a febrile disease with an increase in the lymph nodes and called it an idiopathic inflammation of the lymph glands. The described disease for many years bore his name - Filatov's disease. In 1889, the German scientist Emil Pfeiffer (German Emil Pfeiffer) described a similar clinical picture of the disease and defined it as glandular fever with damage to the pharynx and lymphatic system.

With the introduction of hematological research into practice, characteristic changes in the composition of the blood in this disease were studied, in accordance with which the American scientists T. Sprant and F. Evans called the disease infectious mononucleosis. In 1964, M. A. Epstein and I. Barr isolated a herpes-like virus from Burkitt's lymphoma cells, named after them the Epstein-Barr virus, which was later found with great constancy in infectious mononucleosis.

Pathogenesis

The Epstein-Barr virus is inhaled by a person and infects the epithelial cells of the upper respiratory tract, oropharynx (promoting the development of moderate inflammation in the mucous membrane), from there the pathogen enters the regional lymph nodes with the lymph flow, causing lymphadenitis. When it enters the bloodstream, the virus invades B-lymphocytes, where it begins active replication.

The defeat of B-lymphocytes leads to the formation of specific immune reactions, pathological deformation of cells. With the blood flow, the pathogen spreads throughout the body. Due to the fact that the introduction of the virus occurs in immune cells and immune processes play a significant role in pathogenesis, the disease is classified as AIDS-associated. The Epstein-Barr virus persists in the human body for life, periodically activating against the background of a general decrease in immunity.

Ways of transmission of infection

The Epstein-Barr virus is a ubiquitous member of the herpevirus family. Therefore, infectious mononucleosis can be found in almost all countries of the world, as a rule, in the form of sporadic cases. Often, outbreaks of infection are recorded in the autumn-spring period.

The disease can affect patients of any age, but children, adolescent girls and boys are most often affected by infectious mononucleosis. Babies rarely get sick. After an illness, almost all groups of patients develop stable immunity. The clinical picture of the disease depends on age, sex and the state of the immune system.

Sources of infection are virus carriers, as well as patients with typical (manifest) and erased (asymptomatic) forms of the disease. The virus is transmitted by airborne droplets or through infected saliva. In rare cases, vertical infection (from mother to fetus), infection during transfusion and during sexual contact is possible. There is also an assumption that EBV can be transmitted through household items and through the alimentary (water-food) route.

Epidemiology

The source of infection is a sick person, including those with erased forms of the disease, and a virus carrier. From a sick person to a healthy person, the pathogen is transmitted by airborne droplets, most often with saliva (for example, with a kiss, hence the name “kissing disease”, when using common dishes, linen, bedding, etc.), infection can be transmitted through blood transfusion . Infection is facilitated by crowding and close living of sick and healthy people, therefore, outbreaks of the disease in hostels, boarding schools, camps, and kindergartens are not uncommon.

Mononucleosis is also called the "disease of students", since the clinical picture of the disease develops in adolescence and young age. About 50% of the adult population is infected during adolescence. The maximum incidence in girls is observed at the age of 14-16 years, in boys - at 16-18 years. By the age of 25–35, most people have antibodies to the infectious mononucleosis virus in their blood. However, in HIV-infected individuals, reactivation of the virus can occur at any age.

Symptoms of mononucleosis in a child

The symptoms of infectious mononucleosis are varied. Sometimes there are general signs of a prodormal nature, such as weakness, malaise and catarrhal symptoms. Gradually, the temperature rises to subfebrile, the state of health worsens, a sore throat is observed, nasal congestion worsens breathing. Symptoms of the development of mononucleosis also include pathological growth of the tonsils and hyperemia of the oropharyngeal mucosa.

Sometimes the disease begins suddenly and has pronounced symptoms. In this case, it is possible:

• increased sweating, chills, drowsiness, weakness;
• fever, it proceeds in different ways (usually 38-39C) and lasts several days or even a month;
• signs of intoxication - headache, muscle aches and pain when swallowing.

At the culmination of the disease, the main features of infectious mononucleosis appear, such as:

• angina - on the back wall of the pharyngeal mucosa, granularity, follicular hyperplasia, hyperesia occur, hemorrhage in the mucosa is possible;
• lymphadenopathy - an increase in the size of the lymph nodes;
• lepatosplenomegaly - enlargement of the spleen and liver;
• rash on the skin all over the body;
• general intoxication of the body.

Polyadenitis is traditionally considered the most important symptom of infectious mononucleosis. It occurs as a result of hyperplasia of the lymphoid tissue. In most cases, on the tonsils of the nasopharynx and palate, islet overlays of a gray or whitish-yellowish hue develop. Their consistency is loose and bumpy, they are easily removed.

A rash in mononucleosis most often occurs at the onset of the disease, simultaneously with fever and lymphadenopathy, while it can be quite intense, localized on the legs, arms, face, abdomen and back in the form of small red or pale pink spots. The rash does not require treatment, since it does not itch, it cannot be smeared with anything, it is eliminated on its own as the fight against the virus intensifies. However, if the child was prescribed an antibiotic and the rash began to itch, this indicates an allergic reaction to the antibiotic (most often it is the penicillin series of antibiotics - ampicillin, amoxicillin), since the rash does not itch with mononucleosis.

Infectious mononucleosis is characterized by hepatosplenomegaly, that is, an abnormal enlargement of the spleen and liver. These organs are very sensitive to the disease, so changes in them begin to occur in the first days after infection. The spleen may become so enlarged that its tissues cannot withstand the pressure and it ruptures. In addition, peripheral lymph nodes are enlarged. An actively multiplying virus lingers in them. The lymph nodes on the back of the neck grow especially intensively: they become very noticeable when the child turns his head to the sides. Nearby lymph nodes are interconnected, and almost always their defeat is bilateral.

The first 2-4 weeks there is a continuous increase in the size of these organs, to some extent it continues after the child's recovery. When the body temperature returns to physiological values, the state of the spleen and liver normalizes.

What diseases can be confused with infectious mononucleosis?

Infectious mononucleosis should be differentiated from:

• ARVI of adenovirus etiology with severe mononuclear syndrome;
• diphtheria of the oropharynx;
• viral hepatitis (icteric form);
• acute leukemia.

It should be noted that the greatest difficulties arise in the differential diagnosis of infectious mononucleosis and acute respiratory viral infection of adenovirus etiology, characterized by the presence of a pronounced mononuclear syndrome. In this situation, the hallmarks include conjunctivitis, runny nose, cough and wheezing in the lungs, which are not characteristic of glandular fever. The liver and spleen in ARVI also increase quite rarely, and atypical mononuclear cells can be determined in small quantities (up to 5-10%) once.

In this situation, the final diagnosis is carried out only after serological reactions.

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Diagnosis of the disease

In order to confirm mononucleosis, the following studies are usually prescribed:

• a blood test for the presence of antibodies to the Epstein-Barr virus;
• biochemical and general blood tests;
• Ultrasound of the internal organs, primarily the liver and spleen.

The main symptoms of the disease, on the basis of which the diagnosis is made, are enlarged lymph nodes, tonsillitis, hepatosplenomegaly, and fever. Hematological changes are a secondary sign of the disease. The blood picture is characterized by an increase in ESR, the appearance of atypical mononuclear cells and wide plasma lymphocytes. However, it should be borne in mind that these cells can appear in the blood only 3 weeks after infection.

When conducting differential diagnosis it is necessary to exclude acute leukemia, Botkin's disease, tonsillitis, diphtheria of the throat and lymphogranulomatosis, which may have similar symptoms.

Chronic mononucleosis

Prolonged persistence of the virus in the body is rarely asymptomatic. Considering that with a latent viral infection, the appearance of a wide variety of diseases is possible, it is necessary to clearly identify the criteria for diagnosing chronic viral mononucleosis.

Symptoms of the chronic form:

• a severe form of primary infectious mononucleosis transferred within six months or associated with high titers of antibodies to the Epstein-Barr virus;
• an increase in the content of virus particles in the affected tissues, confirmed by the method of anticomplementary immunofluorescence with the pathogen antigen;
• confirmed histological studies defeat of some organs (splenomegaly, interstitial pneumonia, uveitis, bone marrow hypoplasia, persistent hepatitis, lymphadenopathy).

Complications

Complications of infectious mononucleosis are mainly associated with the development of an associated secondary infection (staphylococcal and streptococcal lesions). Meningoencephalitis, obstruction of the upper respiratory tract by hypertrophied tonsils may occur.

Children may have severe hepatitis, sometimes (rarely) bilateral interstitial infiltration of the lungs. Also, rare complications include thrombocytopenia, overstretching of the lienal capsule can provoke rupture of the spleen.

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How to treat infectious mononucleosis

Therapy of most typical cases of infectious mononucleosis is carried out in the conditions of the infectious department. With a mild course, treatment can be carried out on an outpatient basis, but under the supervision of a local doctor and an infectious disease specialist.

During the height of the pathology, the child must observe bed rest, a chemically and mechanically sparing diet and a water-drinking regimen.

Symptomatic therapy includes antipyretic drugs, local antiseptics for the throat (hexoral, tandum-verde, strepsils, bioparox), analgesics, rinsing the mouth with herbal decoctions, furacilin. Etiotropic treatment (the action is aimed at the destruction of the pathogen) has not been finally determined. In children, it is recommended to use antiviral drugs based on interferon (candles "Viferon"), immunomodulating agents (isoprinosine, arbidol).

In small or weakened babies, the appointment of antibacterial drugs with a wide spectrum of action is justified, especially in the presence of purulent complications(pneumonia, otitis, meningitis). With involvement in the process of the central nervous system, symptoms of asphyxia, a decrease in the work of the bone marrow (thrombocytopenia), hormone therapy is used for 3-5 days.

Rehabilitation

Dispensary observation for 6 months or more with the participation of a pediatrician, an infectious disease specialist, specialists in narrow areas (ENT, cardiologist, immunologist, hematologist, oncologist), using additional clinical and laboratory studies (given in the section Diagnostics + EEG, ECG, MRI, etc.). e).

Also exemption from physical culture, protection from emotional stress - compliance with the security regime for about 6-7 months. You should always stay on the alert, because any compromise can trigger autoimmune reactions.

Prevention

In most situations, infectious mononucleosis proceeds favorably, and yet, like any other infection, this pathology leaves the development of severe consequences such as meningoencephalitis, obstructive respiratory diseases, and pathological enlargement of the tonsils.

Rare consequences of infectious mononucleosis are the development of bilateral interstitial infiltration of the lungs, toxic hepatitis, thrombocytopenia and rupture of the spleen, which can be avoided by observing elementary non-specific preventive measures.

In view of the fact that specific prevention of such a disease as infectious mononucleosis is not carried out, special attention should be paid to non-specific measures to prevent it. The most effective measures for the prevention of infectious mononucleosis are measures that ensure the formation of the normal functioning of the human immune apparatus, which is possible with a healthy lifestyle, rationalization of the eating behavior of people of different ages, the use of various hardening techniques and the periodic use of plant-derived immunomodulators. As such medicines you should use a course of Immunal, Immunorm, which, in addition to stimulating immune reactions, cause activation of the regeneration of mucous membranes that provide full protection of the respiratory system.

Nonspecific prevention of infectious mononucleosis in children involves minimizing possible close oral contact with other people, carrying out an adequate scheme of sanitary and hygienic measures.

Forecast

Most patients have a favorable prognosis. The disease proceeds in mild and erased forms and is easily amenable to symptomatic treatment. Problems occur in patients with low immunity, in which the virus begins to actively multiply, which leads to the spread of infection.

There are no preventive measures against infectious mononucleosis, with the exception of the general strengthening of the body's immune system through a balanced diet, hardening and physical activity. In addition, crowded places should be avoided, the room should be ventilated and such patients should be isolated, especially from children.

Infectious mononucleosis is one of the most common viral infections on earth: according to statistics, 80-90% of adults have antibodies to the pathogen in their blood. It is the Epstein-Barr virus, named after the names of the virologists who discovered it in 1964. Children, adolescents and young adults are most susceptible to mononucleosis. In persons over 40 years of age, it develops extremely rarely, since before this age a strong immunity is formed as a result of an infection.

The virus is especially dangerous for people over 25 years of age, pregnant women (subject to primary infection), as it causes a severe course of the disease, the addition of a bacterial infection can cause miscarriage or stillbirth. Timely diagnosis and competent treatment significantly reduce the risk of developing such consequences.

Pathogen and transmission routes

The cause of mononucleosis is a large DNA-containing virus, a representative of the 4th type of the herpesvirus family. It has a tropism for human B-lymphocytes, that is, it is able to penetrate into them thanks to special receptors on the surface of cells. The virus embeds its DNA into the cellular genetic information, thereby distorting it and increasing the risk of mutations with the subsequent development of malignant tumors of the lymphatic system. Its role in the development of Burkitt's lymphoma, Hodskin's lymphoma, nasopharyngeal carcinoma, carcinoma of the liver, salivary glands, thymus, organs of the respiratory and digestive systems has been proven.

A virus is a strand of DNA wrapped in a protein coat called a capsid. Outside, the structure is surrounded by an outer shell formed from the cell membrane in which the viral particle was assembled. All of these structures are specific antigens, since in response to their introduction, the body synthesizes immune antibodies. The detection of the latter is used to diagnose the infection, its stage and control of recovery. In total, the Epstein-Barr virus contains 4 significant antigens:

• EBNA (Epstein-Barr nuclear antigen) - contained in the core of the virus, is integral part his genetic information;
• EA (early antigen) – early antigen, viral matrix proteins;
• VCA (Viral capsid antigen) – virus capsid proteins;
• LMP (latent membrane protein) – viral membrane proteins.

The source of the pathogen is a person with any form of infectious mononucleosis. The virus is weakly contagious, so long-term and close contact is required for transmission. In children, the airborne route of transmission prevails, and the implementation of the contact route is also possible - through heavily salivated toys and household items. In adolescents and older people, the virus is often transmitted during kissing with saliva, during sexual intercourse. Susceptibility to the pathogen is high, that is, most of those infected for the first time develop infectious mononucleosis. However, asymptomatic and erased forms of the disease account for more than 50%, so often a person does not know about the infection.

The Epstein-Barr virus is unstable in the external environment: it dies when dried, exposed to sunlight and any disinfectants. In the human body, it is able to persist for life, having integrated into the DNA of B-lymphocytes. In this regard, there is another way of transmission - blood contact, infection is possible through blood transfusion, organ transplantation, injection drug use. The virus causes the formation of stable lifelong immunity, therefore, repeated attacks of the disease are the reactivation of the pathogen dormant in the body, and not a new infection.

The mechanism of the development of the disease

The Epstein-Barr virus enters with saliva or its droplets on the mucous membrane of the oral cavity and is fixed on its cells - epitheliocytes. From here, viral particles penetrate into the salivary glands, immune cells - lymphocytes, macrophages, neutrophils and begin to multiply actively. There is a gradual accumulation of the pathogen and infection of all new cells. When the mass of viral particles reaches a certain value, their presence in the body turns on the mechanisms of the immune response. A special type of immune cells - T-killers - destroy infected lymphocytes, and therefore a large amount of biological active substances and viral particles. Their circulation in the blood leads to an increase in body temperature and toxic damage to the liver - at this moment the first signs of the disease appear.

A feature of the Epstein-Barr virus is its ability to accelerate the growth and reproduction of B-lymphocytes - they proliferate with subsequent transformation into plasma cells. The latter actively synthesize and secrete immunoglobulin proteins into the blood, which, in turn, causes the activation of another series of immune cells - T-suppressors. They produce substances designed to suppress the excessive proliferation of B-lymphocytes. The process of their maturation and transition to mature forms is disrupted, in connection with which the number of mononuclear cells, mononuclear cells with a narrow rim of the cytoplasm, increases sharply in the blood. In fact, they are immature B-lymphocytes and serve as the most reliable sign of infectious mononucleosis.

The pathological process leads to an increase in the size of the lymph nodes, since it is in them that the synthesis and further growth of lymphocytes occurs. A powerful inflammatory reaction develops in the palatine tonsils, outwardly indistinguishable from. Depending on the depth of the lesion of the mucous membrane, its changes vary from friability to deep ulcers and plaque. The Epstein-Barr virus inhibits the immune response due to some proteins, the synthesis of which occurs under the influence of its DNA. On the other hand, infected mucosal epithelial cells actively secrete substances that initiate an inflammatory response. In this regard, the number of antibodies to the virus and a specific antiviral substance, interferon, is gradually increasing.

Most of the viral particles are excreted from the body, however, B-lymphocytes with embedded virus DNA remain in the human body for life, which they pass on to daughter cells. The causative agent changes the amount of immunoglobulins synthesized by the lymphocyte, therefore, it can lead to complications in the form of autoimmune processes and atopic reactions. Chronic mononucleosis with a relapsing course is formed as a result of an insufficient immune response in the acute phase, due to which the virus eludes aggression and remains in sufficient quantities to exacerbate the disease.

Clinical picture

Mononucleosis proceeds cyclically and certain stages can be clearly distinguished in its development. The incubation period lasts from the moment of infection to the first signs of the disease and takes an average of 20 to 50 weeks. At this time, the virus multiplies and accumulates in sufficient quantities for massive expansion. The first signs of the disease occur during the prodromal period. A person feels weakness, fatigue, irritability, muscle pain. The prodrome continues for 1-2 weeks, after which the peak of the disease begins. Usually a person becomes ill acutely with an increase in the body to 38-39 degrees C, an increase in lymph nodes.

Symptoms of mononucleosis

The lymph nodes of the neck, neck, elbows and intestines are most often affected. Their size varies from 1.5 to 5 cm; on palpation, a person feels slight pain. The skin over the lymph nodes is not changed, they are not soldered to the underlying tissues, mobile, elastic consistency. A pronounced increase in the lymph nodes of the intestine leads to pain in the abdomen, lower back and indigestion. Significantly, up to the rupture, the spleen enlarges, since it belongs to the organs of the immune system and a large number of lymphatic follicles lie in it. This process manifests itself severe pain in the left hypochondrium, which increases with movement and physical activity. The reverse development of the lymph nodes occurs slowly, within 3-4 weeks after recovery. In some cases, polyadenopathy persists for a long time, from several months to life-long changes.

Temperature in mononucleosis is one of the most common symptoms of mononucleosis. Fever lasts from several days to 4 weeks, can change repeatedly throughout the illness. On average, it starts at 37-38 degrees C, gradually increasing to 39-40 degrees C. Despite the duration and severity of fever general state few patients suffer. Basically, they remain active, there is only a decrease in appetite and increased fatigue. In some cases, patients experience such pronounced muscle weakness that they cannot stand on their feet. This condition rarely lasts more than 3-4 days.

Another constant sign of mononucleosis is angina-like changes in the oropharynx. The palatine tonsils increase in size so much that they can completely block the lumen of the pharynx. On their surface, a white-gray plaque often forms in the form of islands or stripes. It appears on the 3-7th day of illness and is combined with a sore throat and a sharp rise in temperature. The nasopharyngeal tonsil also increases, which is associated with difficulty in nasal breathing and snoring during sleep. The back wall of the pharynx becomes granular, its mucosa is hyperemic, edematous. If the edema descends into the larynx and affects the vocal cords, then the patient develops hoarseness.

Liver damage in mononucleosis can be asymptomatic and with severe jaundice. The liver increases in size, protrudes 2.5-3 cm from under the costal arch, dense, sensitive to palpation. Pain in the right hypochondrium is not associated with food intake, aggravated by physical activity, walking. The patient may notice a slight yellowing of the sclera, a change in skin tone to lemon yellow. Changes do not last long and pass without a trace in a few days.

Infectious mononucleosis in pregnant women- this is, as a rule, reactivation of the Epstein-Barr virus associated with a physiological decrease in immune defense. The incidence increases towards the end of pregnancy and is about 35% of the total number of expectant mothers. The disease is manifested by fever, enlargement of the liver, tonsillitis and the reaction of the lymph nodes. The virus can cross the placenta and infect the fetus, which occurs at high concentrations in the blood. Despite this, infection in the fetus rarely develops and is usually represented by pathology of the eyes, heart, and nervous system.

A rash with mononucleosis appears on average on the 5-10th day of illness and in 80% of cases is associated with taking antibacterial drug- ampicillin. It has a maculopapular character, elements of its bright red color, are located on the skin of the face, trunk and extremities. The rash remains on the skin for about a week, after which it turns pale and disappears without a trace.

Mononucleosis in children often asymptomatic or with an erased clinical picture in the form. The disease is dangerous for babies with congenital immunodeficiency or atopic reactions. In the first case, the virus exacerbates the lack of immune defense and contributes to the attachment of a bacterial infection. In the second, it enhances the manifestations of diathesis, initiates the formation of autoimmune antibodies and can become a provoking factor for the development of tumors of the immune system.

Classification

Infectious mononucleosis according to the severity of the course is divided into:

According to the type of infectious mononucleosis is divided into:

• Typical- characterized by a cyclic course, angina-like changes, enlarged lymph nodes, liver damage and characteristic changes in the blood picture.
• Atypical- combines the asymptomatic course of the disease, its erased form, usually taken for ARVI, and the most severe form - visceral. The latter proceeds with the involvement of many internal organs and leads to serious complications.

According to the duration of the course, infectious mononucleosis can be:

1. acute- manifestations of the disease last no more than 3 months;
2. lingering– changes persist from 3 to 6 months;
3. Chronic- lasts more than six months. The same form of the disease includes repeated fever, malaise, swollen lymph nodes within 6 months after recovery.

A relapse of infectious mononucleosis is the recurrence of its symptoms a month after recovery.

Diagnostics

Diagnosis and treatment of infectious mononucleosis is carried out by an infectious disease specialist. It is based on:

• characteristic complaints- prolonged fever, angina-like changes in the oropharynx, swollen lymph nodes;
• Epidanamnesis- household or sexual contact with a person who had a fever for a long time, blood transfusion or organ transplantation 6 months before the disease;
• Inspection Data- hyperemia of the pharynx, raids on the tonsils, enlarged lymph nodes, liver and spleen;
• Lab results- the main sign of defeat by the Epstein-Barr virus is the appearance in the venous or capillary blood of a large number (more than 10% of the total number of leukocytes) of mononuclear cells. It was for him that the disease got its name - mononucleosis, and before the advent of methods for detecting the pathogen, it was its main diagnostic criterion.

To date, more accurate diagnostic methods have been developed that make it possible to establish a diagnosis even if the clinical picture is not characteristic of the Epstein-Barr virus. These include:

By the ratio of antibodies to various proteins of the virus, the doctor can determine the period of the disease, determine whether there was a primary meeting with the pathogen, relapse or reactivation of the infection:

• The acute period of mononucleosis is characterized by the appearance of IgM to VCA (from the first days of the clinic, persist for 4-6 weeks), IgG to EA (from the first days of the disease, persist throughout life in a small amount), IgG to VCA (appear after IgMVCA, persist for life).
• Recovery is characterized the absence of IgM to VCA, the appearance of IgG to EBNA, a gradual decrease in the level of IgG to EA and IgG to VCA.

High (over 60%) avidity (affinity) of IgG to the Epstein-Barr virus is also a reliable sign of acute or reactivation of the infection.

In the general blood test, leukocytosis is observed with an increase in the proportion of lymphocytes and monocytes up to 80-90% of the total number of leukocytes, an acceleration of ESR. Changes in the biochemical analysis of blood indicate damage to liver cells - the level of ALT, AST, GGTP and alkaline phosphatase increases, the concentration of indirect bilirubin may be increased in jaundice. An increase in the concentration of total plasma protein is associated with excessive production of a number of immunoglobulins by mononuclear cells.

Various imaging methods (ultrasound, CT, MRI, X-ray) allow you to assess the condition of the lymph nodes of the abdominal cavity, liver, spleen.

Treatment

Treatment of mononucleosis is carried out on an outpatient basis with a mild course of the disease, patients with moderate and severe forms are hospitalized in an infectious diseases hospital. Hospitalization is also carried out according to epidemiological indications, regardless of the severity of the disease. These include living in crowded conditions - hostel, barracks, children's home and boarding schools. To date, there are no drugs that can directly affect the cause of the disease - the Epstein-Barr virus and remove it from the body, so therapy is aimed at alleviating the patient's condition, maintaining the body's defenses and preventing negative consequences.

During the acute period of mononucleosis, patients are shown rest, bed rest, plentiful warm drink in the form of fruit drink, weak tea, compote, easily digestible diet. To prevent bacterial complications, it is necessary to rinse the throat 3-4 times a day. antiseptic solutions - chlorhexidine, furacillin, chamomile decoction. Physiotherapy methods - ultraviolet irradiation, magnetotherapy, UHF are not carried out, as they cause additional activation of the cellular link of immunity. They can be used after normalizing the size of the lymph nodes.

Among the medications prescribed:

Treatment of pregnant women is aimed at eliminating symptoms and is carried out with drugs that are safe for the fetus:

• Interferon human in the form of rectal suppositories;
• Folic acid;
• Vitamins E, group B;
• Troxevasin capsules;
• Calcium preparations - calcium orotate, calcium pantothenate.

The average duration of treatment is 15-30 days. After suffering from infectious mononucleosis, a person should be under dispensary observation by a local therapist for 12 months. Every 3 months, laboratory control is carried out, which includes general and biochemical analysis blood, if necessary - the determination of antibodies to the Epstein-Barr virus in the blood.

Complications of the disease

Develop rarely, but can be extremely severe:

1. Autoimmune hemolytic anemia;
2. Meningoencephalitis;
3. Guillain-Barré syndrome;
4. Psychosis;
5. Damage to the peripheral nervous system - polyneuritis, paralysis of cranial nerves, paresis of facial muscles;
6. Myocarditis;
7. Rupture of the spleen (usually occurs in a child).

Specific prophylaxis (vaccination) has not been developed, therefore, general strengthening measures are carried out to prevent infection: hardening, walking in the fresh air and airing, varied and proper nutrition. It is important to treat an acute infection in a timely and complete manner, as this will reduce the risk of chronicity of the process and the development of severe complications.

Video: infectious mononucleosis, "Doctor Komarovsky"

Doctor Maria Nikolaeva

Mononucleosis is a disease that occurs when children are infected with the Epstein-Barr virus (). Infection causes symptoms characteristic of SARS. Intensity clinical picture in this disease depends on the state of the immune system. The latter also determines the likelihood of developing dangerous consequences of mononucleosis in children.

Infectious mononucleosis is acute illness caused by herpes virus. The risk zone for infection includes children aged 3-10 years. Less common in adolescents. In extreme cases, the infection enters the body and manifests in adults.

When examining a child in the blood, a high concentration of atypical mononuclear cells (a type of white blood cell) is detected. After entering the body, the infection affects the lymphatic system, liver and spleen.

Infection of a child with the Epstein-Barr virus occurs in the following ways:

• airborne (the virus is transmitted through kissing, during sneezing, coughing);
• through household items;
• through the blood from mother to child during pregnancy.

The transmission of the virus often occurs in the children's team. Duration incubation period depends on the state of the immune system. On average, from infection to the first signs of the disease, 7-30 days pass. In most patients, mononucleosis is mild.

The danger of the disease lies in the fact that many children have no pronounced symptoms. However, the carrier of the infection remains contagious to the environment. With a latent form of mononucleosis, mild symptoms of colds may appear.

Parents should be aware that the risk of contracting herpes virus increases in the autumn-spring period. This is explained by the fact that at the indicated time the body's resistance to the effects of the external environment decreases. To avoid infection, children in the autumn-spring period are recommended to be transferred to a healthy diet rich in vitamins.

Pathogen

The development of infectious mononucleosis in children occurs after infection with the Epstein-Barr virus. The latter enters the body through the mucous membranes. The causative agents of infectious mononucleosis are embedded in the cells of the nervous system, and therefore type 4 herpes remains “inaccessible” to immune attacks.

In a normal state, the body suppresses the virus. Under the influence of provoking factors that weaken the immune system, the infection is activated and provokes an exacerbation of infectious mononucleosis, and in adults - chronic fatigue syndrome.

Epstein-Barr virus (EBV) in children: symptoms (temperature), consequences, prevention, vaccination