Infectious mononucleosis in a child of 8 months. Infectious mononucleosis in children

Infectious mononucleosis is an acute infectious and inflammatory disease of viral etiology caused by the Epstein-Barr virus or cytomegalovirus. Acute mononucleosis is characterized by the occurrence of fever, tonsillitis, pharyngitis, generalized lymphadenopathies, hepatolienal syndrome, as well as specific changes in blood tests (for mononucleosis, the appearance of atypical mononuclear cells in the blood is specific).

Viral mononucleosis is an acute disease, its chronic course is extremely rare. The disease occurs mainly in children and adolescents. Infectious mononucleosis practically does not occur in adults, since the development of the disease requires primary contact with the Epstein-Barr virus or cytomegalovirus.

Since herpes viruses can persist for life in the blood in adults, as well as in children who have had infectious mononucleosis, the virus may reactivate, that is, a relapse of chronic Epstein-Barr carriage or cytomegalovirus infection with similar clinical symptoms. Reactivation of the virus is possible against the background of favorable conditions for it: decreased immunity after other infectious diseases, severe hypothermia, etc.

Viral mononucleosis in children develops when the Epstein-Barr virus or cytomegalovirus first enters the baby's body. Infectious mononucleosis in children most often occurs at the age of 3-6 years. The second peak of incidence occurs: in girls - at fourteen to sixteen years old, in boys - at sixteen to eighteen years old.

The causative agents of mononucleosis are classified as herpesviruses. Epstein-Barr virus (EBV-human herpesvirus of the fourth type) belongs to gammaherpesviruses, and cytomegalovirus (CMV, HCMV-human herpesvirus of the fifth type) belongs to betaherpes viruses.

It is extremely rare that infectious mononucleosis can develop upon initial contact with the herpes simplex virus type 6 or adenovirus.

How is mononucleosis spread?

Infectious mononucleosis is also called monocytic sore throat, glandular fever, Filatov's disease or “kissing” disease. The disease is transmitted by airborne droplets (more often) or by contact, through saliva (less often).

The disease is slightly contagious, since many patients with good immunity, tolerate the disease in mild forms, believing that it is a common tonsillitis (tonsillitis).

It should be noted that mild forms can have nonspecific, erased symptoms, and in rare cases, be asymptomatic, so some patients do not know whether they have had mononucleosis or not.

You can get infected not only from a patient with acute mononucleosis, but also from a chronic carrier of the Epstein-Barr virus or cytomegalovirus. Susceptibility to the virus does not depend on age, but the likelihood of contracting mononucleosis is higher against a background of decreased immunity, after hypothermia or overheating, stress, etc.

The entrance gates for infection are the mucous membranes of the oropharynx and the upper respiratory tract (upper respiratory tract). Subsequently, the virus spreads lymphogenically through the lymphatic system, entering the regional lymph nodes and organs of the reticuloendothelial system (liver and spleen).

Types, classification of mononucleosis

There is no single classification of the disease. Mononucleosis can be classified by:

• etiology (caused by an Epstein-Barr virus, cytomegalovirus);
• type (typical or atypical forms with an erased or asymptomatic course);
• the severity of the disease (mild, moderate and severe);
• the nature of the course and the presence of complications (smooth or nonsmooth).

The mild course of infectious mononucleosis is divided into:

• complicated, accompanied by the addition of a secondary bacterial flora;
• complicated by exacerbation of other chronic diseases;
• recurrent.

According to the duration of the disease, infectious mononucleosis is divided into acute (lasting up to three months), protracted (from three to six months) and chronic (this diagnosis is rare, mainly in patients with immunodeficiency states and is exposed if the symptoms of the disease persist for more than six months).

Relapse of acute mononucleosis is the reappearance of symptoms of the disease within a month after the infection.

Also, recurrence of chronic carriage of EPV or CMV is possible.

Is it possible to get sick with mononucleosis again

Repeatedly infectious mononucleosis does not get sick. The disease develops when the virus first enters the body. After the transferred infection, stable immunity is formed.

However, given that herpes viruses persist in the blood for life, then when favorable conditions arise (decreased immunity, stress, hypothermia), the activation of the virus is possible. In such a situation, there is a relapse of the chronic carriage of herpes viruses (EPV or CMV).

In immunocompromised patients, the symptomatology of relapse may completely repeat the symptoms of acute mononucleosis.

Mononucleosis in adults

Infectious mononucleosis usually does not occur in adults. In the overwhelming majority of cases, the disease is carried during childhood. In the future, there may be recurrences of the chronic carriage of the virus. Symptoms of mononucleosis in adults do not differ from those in children.

Consequences of mononucleosis in children

As a rule, infectious mononucleosis resolves easily and without any complications. In some cases, the disease can pass in an erased or asymptomatic form.

Even with moderate and severe course, with timely admission to the hospital and adherence to the prescribed regimen (bed rest and diet), as well as drug therapy, the disease has a successful outcome and does not give complications.

However, it should be noted that complications of the disease are rare but severe. Perhaps the development of autoimmune hemolytic anemias, thrombocytopenia, granulocytopenia, airway obstruction (due to a pronounced increase in lymph nodes), encephalitis, rupture of the spleen.

How does the disease develop?

After the EPB and CMV viruses enter the oropharynx, they begin to multiply actively. The only cells in the human body that have specific receptors for these viruses are B-lymphocytes. In the acute period of the disease, the content of viral antigens can be noted in more than twenty percent of B-lymphocytes in the blood.

After acute infectious and inflammatory processes subside, viruses can be detected only in single B-lymphocytic cells and the epithelium lining the nasopharynx.

It should be noted that some of the cells damaged by EPV or CMV die, as a result of which the virus is released and continues to infect new cells. This leads to disruption of both cellular and humoral immune responses and can lead to the attachment of a secondary bacterial component.

The main clinical symptoms of infectious mononucleosis are associated with the ability of EPB and CMV viruses to infect lymphoid and reticular tissues. Clinically, this is manifested by generalized lymphadenopathies and hepatolienal syndrome (enlarged liver and spleen).

An increased mitotic activity of lymphoid and reticular tissues in response to an acute viral infection leads to the appearance in the patient's blood of atypical virocytes (mononuclear cells). At the same time, atypical virocytes are able to synthesize specific heterophilic antibodies to the virus.

After the transferred mononucleosis, stable immunity is formed. The EPB or CMV virus persists in the blood for life, being in a dormant, inactivated state.

With repeated contact with the virus, or when favorable conditions arise for its reactivation, only an increase in the titer of specific antibodies in the blood occurs.

Clinically, exacerbation of chronic carriage can manifest itself with symptoms similar to acute mononucleosis, however, in a more smoothed form.

Diagnosis of mononucleosis

In blood tests for mononucleosis in children, the presence of:

• leukopenia, or moderate leukocytosis;
• lymphomonocytosis;
• neutropenia;
• monocytosis;
• atypical mononuclear cells.

In blood biochemistry, hyperbilirubinemia and slight hyperenzymemia can be noted.

During the polymerase chain reaction, viral DNA (EPB or CMV) is detected in the patient's blood.

Specific antibodies and the virus activity index are assessed using a serological blood test (IgM, IgG).

Ultrasound of the abdominal organs is characterized by an increase in the mesenteric lymph nodes, liver and spleen.

Mononucleosis in children - symptoms and treatment

Typical forms of mononucleosis are accompanied by the development of:

• severe intoxication syndrome;
• prolonged fever;
• systemic lymphadenopathy;
• hepatomegaly;
• splenomegaly;
• adenoiditis;
• specific hematological changes;
• exanthema syndrome (a rash with mononucleosis can occur after taking ampicillin or amoxicillin).

The incubation period for mononucleosis ranges from four to fifteen days (usually about a week). For the disease, an acute onset is indicative, with the development of febrile and acute intoxication syndromes.

The maximum severity of fever reaches the second or fourth day of the disease. The temperature can reach 40 degrees, patients complain of lethargy, soreness of muscles and joints, chills, nausea. Fever is usually wavy and lasts 1 to 3 weeks.

Subsequently, complaints of a sore throat, aggravated by swallowing, are added, nasal congestion associated with an increase in adenoids due to damage to the lymphoid and reticular tissues by the virus. Many parents note that the child began to snore during sleep.

The development of tonsillitis can be noted both from the first day and from the fifth or seventh day of the disease. With infectious mononucleosis, the appearance of catarrhal, lacunar or ulcerative-necrotic tonsillitis is noted. The last two types are characteristic for the attachment of a secondary bacterial infection (beta-gamolytic streptococcus, pneumococcus, etc.).

The most specific feature of mononucleosis is lymphadenopathy. As a rule, an increase in the submandibular, cervical and occipital lymph nodes (LN) is characteristic. However, there may be an increase in other groups of lymph nodes. Some patients may have a picture of acute mesenteric adenitis.

Lymph nodes can be of different sizes. As a rule, they grow up to 2-2.5 cm. However, they can grow up to 3-3.5 and more centimeters. Lymph nodes are dense, mobile, palpation discomfort is possible. Sharp soreness is not typical. LN can increase in chains, and an increase in single lymph nodes is also possible.

The liver and spleen can be enlarged from one to two cm from under the costal arch (with mild flow), up to three to four cm (liver) and two to three centimeters (spleen) below the costal margin.

With a pronounced enlargement of the liver and spleen, patients may complain of painful sensations in the abdomen, aggravated by eating or moving.

In rare cases, mild jaundice may occur.

A rash with mononucleosis is uncommon (10% of patients), however, some patients may have a measles-like (maculopapular), small-spotted, roseolous rash.

It should be noted that the appearance of a rash with infectious mononucleosis is noted in 90% of patients, if they start taking ampicillin or amoxicillin preparations. These antibacterial agents are contraindicated in mononucleosis precisely because of the high risk of rash.

Infectious mononucleosis in children photo:

Enlarged lymph node Enlarged lymph nodes with mononucleosis

Treatment of mononucleosis in children

The amount of drug treatment for infectious mononucleosis depends on the severity of the disease. General recommendations for all patients will be adherence to diet No. 5, bed rest until the end of the fever, with a further transition to semi-bed rest. Throughout the acute period, the patient should be isolated.

Symptomatic therapy is also used: desensitizing agents, antipyretics, local antiseptic throat sprays, vitamins.

Etiotropic therapy consists in the use of drugs or valacyclovir and suppositories with human recombinant alpha2b interferon.

It is advisable to prescribe antibiotics for mononucleosis when a secondary bacterial component is attached (abundant purulent deposits on the tonsils). Of the antibacterial drugs, cephalosporins are used (,).

It is important to remember that ampicillin®, amoxicillin® and azithromycin® are contraindicated in infectious mononucleosis, as they increase the risk of developing a rash.

With frequent relapses, Isoprinosine ® (an immunostimulating and antiviral drug) can be used.

Diet for mononucleosis in children

Infectious mononucleosis in children is an acute infectious disease that affects the lymphatic and reticuloendothelial systems and manifests itself with fever, polyadenitis, tonsillitis, hepatosplenomegaly, leukocytosis with a predominance of basophilic mononuclear cells.

Source: razvitierebenka.info

The infection is widespread, seasonality has not been identified. Infectious mononucleosis in children of the first two years of life is practically not observed. With age, the incidence rate increases and reaches a maximum in puberty, then gradually decreases again. Boys get sick twice as often as girls.

Death in infectious mononucleosis is extremely rare. It can be caused by rupture of the spleen and obstruction of the airways.

Synonyms: glandular fever, Filatov's disease, benign lymphoblastosis, “kissing disease”.

Causes and risk factors

The causative agent of infectious mononucleosis is the Epstein-Barr virus (EBV), one of the members of the herpevirus family. Unlike other herpes viruses, it stimulates the growth of host cells (mainly B-lymphocytes), rather than causing them to die. It is this factor that experts explain the carcinogenicity of the Epstein-Barr virus, i.e., its ability to provoke the development of oncological diseases, for example, nasopharyngeal carcinoma or Burkitt's lymphoma.

Source: okeydoc.ru

The only reservoir of infection is the carrier of the infection or the sick person. The virus is shed on Wednesday in the 18 months after the initial infection. The main route of transmission is airborne (when coughing, sneezing, kissing), in addition, sexual, intranatal (from mother to child) and transmissible (with blood transfusion) are possible.

Natural susceptibility to infection is high, but infection usually develops an erased or mild form of the disease. The low incidence of infectious mononucleosis in children in the first two years of life is explained by passive immunity received from the mother during intrauterine development and breastfeeding.

Infectious mononucleosis in children with immunodeficiency conditions can be difficult, with generalization of the infectious process.

Once in the human body, the virus infects the epithelial cells of the upper respiratory tract and oropharynx, contributing to the onset of moderate inflammation. Then, with the flow of lymph, it penetrates into the nearest lymph nodes, leading to the development of lymphadenitis. After that, it enters the bloodstream and is introduced into B-lymphocytes, where it replicates (multiplies), leading to cell deformation. The Epstein-Barr virus persists for a long time in the body, with a decrease in general immunity, its reactivation occurs.

Preventive measures aimed at reducing the incidence of infectious mononucleosis in children are similar to those in acute respiratory viral infections.

Symptoms of infectious mononucleosis in children

The incubation period can vary widely (from 3 to 45 days), but more often it is 4–15 days.

In most cases, the disease begins acutely, but sometimes a detailed clinical picture may be preceded by a prodromal period, the signs of which are:

• sore throat;
• nasal congestion;
• general malaise, weakness;
• subfebrile temperature;

The most dangerous complication is rupture of the spleen. It is observed in about 0.5% of cases, accompanied by massive internal bleeding.

The peak phase lasts on average 2-3 weeks, after which the body temperature decreases, the size of the liver and spleen return to normal, the symptoms of tonsillitis disappear. Subfebrile condition and adenopathy persist for several weeks.

In some cases, acute infectious mononucleosis in children can become chronic. Most often, the chronic active course of the disease is observed in children with weakened immunity (transplant recipients, HIV-infected patients). The chronic active course of the disease is characterized by a high titer of antibodies to the capsid antigens of the Epstein-Barr virus and histologically confirmed changes in a number of organs (persistent hepatitis, lymphadenopathy, uveitis, hypoplasia of the elements of the bone marrow, interstitial pneumonia).

Symptoms of chronic infectious mononucleosis in children:

• exanthema;
• subfebrile temperature;
• signs of damage to the central nervous system.

The congenital form of infectious mononucleosis in children is characterized by multiple malformations (cryptorchidism, micrognathia, etc.).

Diagnostics

Laboratory diagnosis of infectious mononucleosis in children includes the following methods:

• a general blood test - leukocytosis, lymphocytosis, monocytosis, thrombocytopenia, the appearance of atypical mononuclear cells (lymphoblasts, precursors of cytotoxic T cells, actively participating in the removal of B-lymphocytes affected by the Epstein-Barr virus) are detected;
• biochemical blood test - hypergammaglobulinemia, hyperbilirubinemia, the appearance of cryoglobulins in the serum;
• detection of specific antibodies to viral proteins (reaction of indirect immunofluorescence, drop test);
• virological research - detection of the Epstein-Barr virus in the lavage from the oropharynx. In clinical practice, it is used extremely rarely due to the complexity and high cost of this study.

Acetylsalicylic acid should not be prescribed to children in order to lower the temperature, since its intake is accompanied by a high risk of Reye's syndrome.

The presence of infectious mononuclear cells in the blood can be detected in children not only with infectious mononucleosis, but also with HIV infection. Therefore, when they are detected, the child must be subjected to an enzyme immunoassay for HIV infection, and then this analysis is repeated twice more with an interval of three months.

Infectious mononucleosis in children requires differential diagnosis with listeriosis, leukemia, lymphoma, toxoplasmosis, viral hepatitis, viral tonsillitis of a different etiology, streptococcal pharyngitis, adenovirus infection, rubella, diphtheria, cytomegalovirus infection, side effects from drugs.

Treatment of infectious mononucleosis in children

In most cases, the disease is treated on an outpatient basis. In the acute phase, bed rest is prescribed, as the condition of the sick child improves and the severity of intoxication decreases, the regime is gradually expanded.

Since the etiotropic treatment of infectious mononucleosis in children has not been developed, symptomatic therapy is performed. For high fever, nonsteroidal anti-inflammatory drugs are prescribed. Acetylsalicylic acid should not be prescribed to children in order to lower the temperature, since its intake is accompanied by a high risk of Reye's syndrome.

When a secondary bacterial infection is attached, antibiotics of the penicillin series are prescribed (penicillin, oxamp, ampicillin, oxacillin). Levomycetin and sulfa drugs are not prescribed for children with infectious mononucleosis, since they have a depressing effect on the red bone marrow.

With the development of specific complications of infectious mononucleosis (obstruction of the airways with hyperplastic tonsils), glucocorticosteroids are shown in a short course.

One of the main symptoms of infectious mononucleosis in children is tonsillitis, which occurs from the first days of the disease.

In the event of a ruptured spleen, an emergency surgical intervention is required - splenectomy.

In the complex treatment of infectious mononucleosis in children, diet therapy is of great importance. Since the disease proceeds with impaired functions of the liver and spleen, the optimal diet is table No. 5 according to Pevzner. The main characteristics of this diet are:

• the content of proteins and carbohydrates meets the needs of the child's body;
• restriction in the diet of fats, especially of animal origin;
• dietary cooking: cooking, baking, stewing;
• exclusion from the diet of foods rich in oxalic acid, purines, extractives, coarse fiber;
• eating 5-6 times a day in small portions at regular intervals.

Sample menu for one day

• first breakfast - oatmeal, curd pudding, milk tea;
• second breakfast - fruits, grated carrots with an apple, tea with lemon;
• lunch - vegetarian potato soup with a teaspoon of sour cream, baked meat with white sauce, stewed zucchini, rye bread, apple jelly;
• afternoon tea - biscuit biscuits, rosehip broth;
• dinner - mashed potatoes with boiled fish, white bread, tea with lemon.

Possible complications and consequences of infectious mononucleosis in children

The most dangerous complication is rupture of the spleen. It is observed in about 0.5% of cases, is accompanied by massive internal bleeding and requires immediate surgical intervention for health reasons.

Other consequences of infectious mononucleosis in children can be:

• monoarthritis;
• mild hemolytic anemia;

  Prophylaxis

  Preventive measures aimed at reducing the incidence of infectious mononucleosis in children are similar to those in acute respiratory viral infections. The sick child is isolated in a separate room. Wet cleaning is carried out daily using disinfectants, the room is often ventilated.

  A vaccine for specific prophylaxis of Filatov's disease has not been developed. Nonspecific measures for the prevention of infectious mononucleosis in children are to increase the general protective forces (the appointment of adaptogens, mild immunoregulators, the conduct of health measures).

  Emergency prophylaxis of infectious mononucleosis in children in contact with patients is rare. Indications for the appointment of a specific immunoglobulin are immunodeficiency states.

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

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

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

What is mononucleosis

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

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

Symptoms of mononucleosis

Disease develops gradually, starting with fever and severe sore throat: angina occurs. Patients complain of well-being, loss of strength and loss of appetite. Characteristically, smokers lose the desire to smoke.

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

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

From the first days of illness increase in size liver and spleen, reaching a maximum by 4-10 days. Sometimes dyspeptic symptoms, abdominal pains are noted. In 5-10% of patients, there is a slight icterus of the skin and sclera.

Other symptoms appear:

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

In some cases, an increase in the activity of transaminases in the blood is detected, which indicates a violation of liver function. At the height of the illness or at the beginning of the recovery period, patients receiving antibiotics develop an allergic rash (maculopapular, urticarial, or hemorrhagic). This happens more often when prescribing penicillin drugs, as a rule, ampicillin and oxacillin (antibodies to them are found in the blood of patients).

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

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

Symptoms of mononucleosis in children

Children complain of the following symptoms:

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

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

Important: sometimes the course of mononucleosis becomes acute. The child develops chills, fever reaches 39 ° -40 °. The increased temperature lasts for 7-10 days, and sometimes longer. Symptoms from the nasopharynx often join this.

The latter in some children are unremarkable (catarrh of the nose or throat), in others - tonsillitis, which sometimes takes on an ulcerative and even diphtheria character. The changes that have occurred in the throat and tonsils become the gateway for a secondary infection, sometimes septic.

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

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

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

The nodes grow either singly or in groups. As a rule, the nodes are small, elastic, painful when pressed, which often occurs in the cervical nodes and then only if there are large changes in the tonsils. Symmetrical enlargement of nodes rarely occurs. Abdominal pain, nausea, vomiting, and diarrhea are associated with enlargement of the mesenteric nodes.

Descriptions of the symptoms of mononucleosis

Diagnosis of mononucleosis

Infectious mononucleosis is diagnosed based on several tests:

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

When a single blood test fails to identify the cause of the symptoms, the presence of antibodies to the Epstein-Barr virus is determined. Research is often ordered PCR which helps to get results quickly. Diagnosis is sometimes done to identify HIV infection, which manifests itself as mononucleosis.

To determine the causes of the angina that has arisen and to differentiate from other diseases, a consultation with an otolaryngologist is appointed, who does a pharyngoscopy, which helps to determine the cause of the disease.

Mononucleosis treatment

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

Which doctors should i contact for mononucleosis

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

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

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

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

Medications

Important: drugs of the penicillin group are contraindicated.

Typically, the following drugs are prescribed for mononucleosis:

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

Treatment of mononucleosis in children

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

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

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

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

• milk products;
• fish;
• lean meat;
• soups (preferably vegetable);
• mashed potatoes;
• porridge;
• fresh vegetables;
• fruit.

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

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

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

Instructions for the use of drugs for mononucleosis

Recovery from mononucleosis

Recovery from infectious mononucleosis occurs under the supervision of a doctor... Consultations with a hepatologist are required, as well as regular biochemical, serological examinations and blood tests.

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

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

For the prevention of complications mononucleosis, children need to follow some recommendations for six months:

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

Complications of mononucleosis

Typically, mononucleosis ends complete recovery.

But sometimes there are serious complications:

• febrile syndrome;
• pneumonia;
• uveitis.

Neurological complications

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

Hematologic complications

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

Ruptured spleen

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

Causes of mononucleosis

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

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

How can you get mononucleosis?

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

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

Half of people carry infectious mononucleosis in adolescence: boys at 16-18 years old, girls at 14-16 years old, later the incidence rate decreases.

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

How not to get infected with mononucleosis

There is no vaccination against infectious mononucleosis. No special preventive measures aimed at preventing this particular disease - too. The doctors' recommendations boil down to the fact that it is required to increase immunity and carry out the same preventive measures as for other viral infections.

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

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

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

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

If a child attending Kindergarten, it is required to carry out a thorough wet cleaning of the group premises, using disinfectants. Shared items (dishes, toys) are also subject to disinfection.

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

Questions and answers on the topic "Mononucleosis"

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

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

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

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

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

Tell me what tests are needed to detect mononucleosis?

Blood test.

I am 29. Three weeks ago, a lymph node on the right side of the neck increased and became ill, the next day it was the same with the left and the throat was very swollen. After 4 days, the throat passed, a severe cough began and the temperature rose to subfebrile. After another 3 days, the temperature rose to 38, was prescribed ceftriaxone, the temperature increased every day, on the sixth day of the antibiotic it began to fall to normal values, the lymph nodes returned to normal. After 4 days, low-grade fever again, after another 2 days, severe swelling of the throat and enlargement of lymph nodes throughout the body. At the same time, severe sweating at night for two weeks and a dry cough. Could it be mononucleosis?

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

I am 62 years old. At the end of July, my throat ached - I still can't cure it. Visited an ENT doctor. Has passed the tests - the BARRA virus - 650. The doctor said that she had once been ill with mononucleosis and had very low immunity. Having found your site, I read that recurrent mononucleosis is impossible, so why can't I cure my throat. And which doctor should I go to (at the moment I rinse alternately with chamomile, diluted alcoholic extract of propolis, tanzelgon and Lugol) or is it all about immunity? And what will YOU advise?

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

Can there be complications on the joints after the mononucleosis transferred a month ago?

Unlikely.

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

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

My child is 1.6 months old. We went to the nursery for 4 days and got sick with mononucleosis. 7 days the temperature was under 40. We were admitted to the hospital. We pierced 7 days with antibiotics and continue to drink acyclovir. Now he has pimples. Is it an allergy or is this how the disease manifests itself? What to do?

In the midst of the disease, patients receiving antibiotics often develop an allergic rash. This is more often observed when prescribing drugs of the penicillin series. Tell your doctor about this.

A 3-year-old child has suffered from infectious monucleosis, after which he has ARVI every month. How does monucleosis affect the immune system, what is the most effective treatment and prevention of consequences?

In our opinion, the cause of frequent episodes of acute respiratory viral infections in a child is not mononucleosis, but another reason (decreased immunity), which, possibly, led to the fact that the child developed mononucleosis. Infectious mononucleosis does not have a long-term effect on the immune system and does not cause late complications. To carry out the prevention of ARVI, it is necessary to strengthen the immune system.

Please tell me, a 14-year-old child has had mononucleosis. How to determine if there are complications? Friends advised us to donate blood for AST and ALT. is it necessary? And is it necessary to test for antibodies to mononuclear cells?

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

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

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

A 15-year-old boy suspected of infectious mononucleosis is ill for 5 days: severe sore throat, nasal congestion, lack of appetite, severe weakness, headache, high temperature has been lasting for 4 days (38.7-39.1). I knock down with nurofen (2 days), take zinnat (2 days), tantum-verde, nazivin, aqualor, rinse. Before nurofen, she knocked down with panadol (2 days). On palpation, the liver is enlarged, white plaque on the tonsils (foul angina). Why does the temperature keep on holding? Isn't it harmful to take Nurofen for more than 3 days? And how long can a high temperature last? Tomorrow we will have a general urine and blood test.

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

Six months ago I had an infectious mononucleosis. I carried it on my feet, because I didn’t know. Then I just passed the tests for infections and found that I had had it. There was a high temperature, enlarged cervical and occipital lymph nodes. After that I felt fine. The infectious disease specialist said that I no longer need her treatment, and why the temperature - let other doctors find out why. Now, for half a year now, I have a long-term subvereignty. Malaise. Weakness. In the morning the temperature is 35.8, in the evening it rises. None of the doctors can say anything. And literally 3 days ago I also caught a cold. Conventional ODS. But it is impossible to sleep at night, the lymph nodes on the back of the head and ear have increased. Now I don't know what it is. What is it connected with !!! Help me please!!

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

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

Vaccinations in this case can be done.

How can you quickly and effectively raise a child's immunity after mononucleosis?

Immunity is too complex and subtly arranged system and therefore from any too sharp and active influences it can be upset.

My 12 year old son suffered a severe form of mononucleosis in June. At this time, we are taking cycloferon. Recently, the child began to complain of strong, frequent heartbeats. In a calm state, without physical exertion, the pulse can reach 120 beats per minute with an arterial pressure in the range of 120/76 - 110/90. Cases of heart palpitations like this happen even at night. Can these symptoms indicate any complication after the previous illness? Or is it something else? And which doctor should I see?

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

Can you get infectious mononucleosis again?

Recurrence is practically impossible.

My 12 year old son has mononucleosis. The acute stage of the disease has passed. Now we are completing the treatment at home. I was constantly near the picture, practically did not leave. I am 41. Now I felt bad too. The temperature is 37.3 - 37.8. Great weakness. Sore throat, nose periodically does not breathe. The feeling that this pain and discomfort wants to get into the ears. Eyes were very red. Can I now become a carrier of this virus or get mononucleosis myself?

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

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

In most cases, the course is favorable, which makes it possible to treat at home, but despite this, you should keep the child under the supervision of a doctor. The most dangerous complication of mononucleosis is rupture of the spleen, so make sure that for some time after recovery, the child refrains from active games that can lead to a fall or injury to the abdomen.

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 an ordinary respiratory infection in its manifestations, but at the same time its course affects the state of internal organs. A characteristic feature of mononucleosis is enlargement of the lymph glands of the body, especially the spleen. The disease also negatively affects the condition of the respiratory system and liver.

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

Epstein-Barr virus under a microscope

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

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

❗However, knowledge of the symptoms also does not always guarantee timely detection of the disease. There are frequent cases of atypical mononucleosis, when the symptoms are strongly smoothed out or completely erased, and the disease is diagnosed accidentally in the course of other studies. Mononucleosis, on the other hand, can be overly severe.

Mononucleosis spreads mainly from person to person in everyday situations: eating from a common dish, sneezing, coughing, kissing.

☝Infection increases dramatically in closed and semi-closed institutions - schools, kindergartens, sections, etc. Given that the disease most often affects children under 10 years of age, these places are becoming the main source of the epidemic.

As already mentioned, in a considerable number of cases, the disease does not manifest itself in any way, however, a 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 erased form

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

Symptoms of infectious mononucleosis

In most cases, it is impossible to say for sure from whom the virus was transmitted to a particular patient. The source of infection may feel completely healthy and unaware of its carrier. In the meantime, you can get infected from it even during 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 patient's body characteristics, the incubation period can last up to one and a half months. Only after this do clinical signs appear. As a rule, for such a period it is impossible to remember exactly with whom the child had potentially dangerous contact.

❗If the 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 the characteristic sign does not appear, then the immunity has coped with the disease.

The most common symptoms of MI

Often the illness begins with general intoxication, typical of any other viral illness - for example, the flu. The patient feels chills, weakness, fever. Skin rashes and palpable lymph nodes are characteristic. Such manifestations are a reason to immediately contact a pediatrician.

The symptoms of mononucleosis can be very varied. Most often, the temperature rises quite quickly to subfebrile levels, constant sore throat begins, difficulty breathing and swallowing - this is an indicator of enlargement of the tonsils. Visually, the throat is red, swollen, the nose is also congested due to swelling of the mucous membrane.

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

Temperature for infectious mononucleosis within 38 degrees

In the first week (sometimes longer), the child is constantly shivering, weakness and drowsiness, headache, pain when swallowing and aching muscles. At the same stage, at the onset 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 rash goes away on its own when treating the underlying disease.

Swollen lymph nodes are considered the most important symptoms of the disease.

Swollen lymph nodes with myocardial infarction

They can change on any part of the body, are easily felt, while the patient experiences painful sensations. In the throat on the tonsils, polyadenitis occurs - deposits of a gray or white-yellow hue, which are easily removed, but are a sign of lymphoid tissue hyperplasia.

Rash on the body with myocardial infarction

➡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 both in manifestation and in severity, therefore, 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 for specific antibodies.

A blood test detects mononuclear cells

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, the ESR value - the erythrocyte sedimentation rate - is pathologically increased. 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 symptom is noted not at the initial stage of the disease, but 2-3 weeks after its development.

➡ The test for specific antibodies allows the laboratory to carry out differential diagnosis with other diseases. This analysis is especially important in case of an 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 assess their condition and choose symptomatic treatment that will preserve the functionality of these organs, avoiding surgery.

PCR method is one of the most accurate

✔ In addition, it is necessary to re-undergo serological tests for several months, which will allow differentiating laboratory parameters of mononucleosis from HIV infection (these conditions have a similar picture in the 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 cure 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, subject to regular visits to the doctor.

However, in severe cases (especially for infants), hospitalization of the child in the hospital is indicated. The hospitalization 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 means 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 angina, local antiseptics are used, and immunomodulating nonspecific drugs are prescribed to maintain the body's defenses. Antibiotics orally or by injection are prescribed only if a bacterial infection is attached and detected in the tests.

Often, the treatment of mononucleosis is accompanied by the appointment of fortifying vitamin agents, because the body loses many beneficial substances while fighting 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 vivid signs of toxicosis, a short-term course of prednisolone is prescribed in a hospital setting. The drug is also used when there is a high risk of asphyxia. Also, with edema of the larynx and severe breathing difficulties, a tracheostomy is installed, and the child is transferred to artificial ventilation.

Another dangerous complication of mononucleosis is rupture of the spleen. To avoid this, ultrasound monitoring of the organ's condition is regularly carried out, and in the event of a rupture, a surgical operation is required.

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

⚠However, with such treatment, a complication can easily develop, which in turn threatens with consequences and even death.

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

• Sweet soda;
• Spicy sauces, ketchup, mayonnaise;
• Coffee, cocoa, chocolate;
• Meat broths;
• Fatty meat dishes;
• Spicy dishes, condiments, 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 for the child to consume a lot of liquid - it can be both ordinary water and compotes, decoctions of fruits, 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 best if the food is chopped or served in a semi-liquid state. Warm weakly brewed tea or herbal teas are also suitable as a drink.

In the early days of acute onset of symptoms, the child may have no appetite at all. In this case, you should not force-feed him, it is only important to make sure that he drinks enough fluids, especially if fever and vomiting are present in the symptoms.

⚠Children are easily dehydrated and fluid imbalances can negatively affect 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 protracted or severe course of the disease, the patient may develop hepatitis, liver failure (especially in the case of 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 advisable to carry out treatment in a hospital, under the supervision of doctors.

Complications - hemorrhages

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, because 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 prevention of mononucleosis as such.

When registering an outbreak of the disease, patients should be isolated from staying in collectives (especially if these are 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 physical activity, staying in the fresh air, a healthy diet and timely treatment of infections.

An important step in maintaining immunity is a competent alternation of sleep and wakefulness and a sufficient duration. This is especially true for schoolchildren and students. Sleep deprivation, like a fragmented regimen, has been shown to reduce the body's natural defenses.

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

Infographics - symptoms, diagnosis, treatment

Save yourself the infographic

Infectious mononucleosis was first described by N. Filatov at the end of the 19th century. The disease is called idiopathic lymphadenitis. This is an acute viral infection, which is characterized by a change in lymph, enlargement of the liver and spleen, and congestion of the throat. The disease is caused by the Epstein-Barr virus type 4, which destroys the lymphoid-reticular tissue.

Infectious mononucleosis is common in children, especially those under 10 years of age. Boys are 2 times more likely to be exposed to it than girls. Most people on the planet suffer from mononucleosis, but 80% of patients have blurred symptoms or an asymptomatic course. Symptoms are especially pronounced in weakened children with low immunity.

Causes of development and ways of infection

Children after 3-5 years usually stay in closed groups of a kindergarten or school, so the most likely to get sick with mononucleosis is there. The virus is transmitted by airborne droplets or by household means by close contact between the carrier and a healthy person. In the environment, the causative agent of the disease dies very quickly. In a sick child, it is in the saliva for another 6 months after the cure and can be transmitted by:

• cough;
• kiss;
• using one dish, hygiene products.

Sometimes the virus is transmitted by transfusing blood contaminated with it into a healthy person. It is difficult for children under 10 years of age to diagnose mononucleosis, since it has an erased clinical picture and passes quickly. In adolescents and adults, the course of the disease can last for months. If a child has been ill once, he develops lifelong immunity, but the Epstein-Barr virus remains in the body.

Characteristic signs and symptoms

There is no prophylaxis against infection with viruses today, so it is necessary to pay attention to the symptoms that may indicate an infection of the child. In infectious mononucleosis, they can be varied. The disease can be almost asymptomatic or have a pronounced clinical picture.

From the moment the virus enters the body until the first manifestations of the disease, it can take from 1 week to several months. The child develops general weakness, malaise. In the process of disease progression, the patient's state of health becomes worse. The temperature rises to subfebrile levels, a feeling of sore throat, nasal congestion appears. Redness of the throat mucosa, proliferation of the tonsils is characteristic of mononucleosis.

With a pronounced course of the disease, there may be a fever that lasts for several days. Moreover, the patient has the following symptoms:

• excessive sweating;
• headache;
• pain when swallowing;
• drowsiness;
• muscle aches.

After that, specific symptoms of infectious mononucleosis increase:

• hyperemia of the posterior wall of the throat mucosa, its hemorrhage;
• an increase in peripheral lymph nodes;
• general intoxication;
• enlargement of the spleen and liver;
• rash on the body.

Rashes may appear at the beginning of the infectious process along with fever. They look like specks of pale pink or red color, which are localized on different parts of the body (face, abdomen, limbs, back). The rash does not need treatment. It does not cause itching and goes away gradually on its own.

A hallmark of mononucleosis is polyadenitis due to hyperplasia of lymphoid tissue. Greyish or yellow-white lumpy deposits form on the tonsils. They have a loose structure and can be easily removed.

The child has an increase in the cervical lymph nodes (sometimes up to 3 cm). They become a barrier to the active virus. The lymph nodes in the back of the neck are especially noticeable. In most cases, the defeat of the lymph nodes is bilateral. There is practically no pain on palpation. Rarely, there is an increase in lymph nodes in the abdominal cavity, in which the child may show signs of an acute abdomen.

The liver and spleen are very sensitive to the Epstein-Barr virus. Therefore, changes occur in them immediately after infection of the organism. For about 2-4 weeks, these organs continuously increase in size. Then they gradually return to their normal physiological position.

Diagnostics

Since the symptoms of infectious mononucleosis are very blurred, it is necessary to pass several tests to confirm the diagnosis:

• general and biochemical blood test;
• blood to determine the titer of antibodies to the Epstein-Barr virus;
• Ultrasound of internal organs.

According to external signs, it is difficult for a doctor to differentiate angina and mononucleosis. Therefore, serological tests are carried out. A complete blood count (CBC) can show elevated levels of white blood cells, lymphocytes, and monocytes. With mononucleosis in the blood, the content of atypical mononuclear cells increases. But they appear only 2-3 weeks after the virus enters the body. Also, when making a diagnosis, it is necessary to exclude diseases such as diphtheria, leukemia, Botkin's disease.

Methods and rules of treatment

There is no specific treatment for infectious mononucleosis in children. The doctor prescribes only symptomatic treatment to alleviate the child's condition. For the first 2 weeks, you need to adhere to bed rest. Antibiotics are not effective for a viral infection (only for a secondary infection). In addition, they reduce an already weakened immune system.

Drug therapy

At high temperatures, antipyretic drugs are indicated:

• Ibuprofen;
• Paracetamol;
• Efferalgan.

Attention parents! With infectious mononucleosis, it is forbidden to use aspirin to lower the temperature in a child in order to avoid the development of Reye's syndrome.

To treat the throat, antiseptic local remedies are used, as for angina:

• Tandum Verde;
• Orasept;
• Furacilin;
• Chlorophyllipt.

If there are signs of rhinitis, the use of vasoconstrictor drops is indicated (no longer than 5 days):

• Nazivin;
• Otrivin;
• Nazol.

As an immunomodulatory therapy, the following agents are used:

• IRS 19;
• Imudon;
• Viferon;
• Anaferon.

They are effectively used together with antiherpetic drugs (Acyclovir). Rarely, in severe cases of mononucleosis, anti-inflammatory hormonal agents (Prednisolone) are prescribed. It is imperative to support the child's body with a sufficient amount of vitamins.

Hepatoprotectors and choleretic agents for liver changes:

• Hofitol;
• Allochol;
• Hepabene.

In the case of a bacterial infection, antibiotics (except for penicillins) are required. In parallel, you need to take probiotics to normalize the intestinal microflora (Linex, Narine).

A child needs to be hospitalized if he has:

• temperature is above 39 ° C;
• severe general intoxication;
• the threat of asphyxiation;
• other complications.

Diet and diet

A child will recover faster from infection with the virus if he is provided with the correct drinking and nutritional regimen. Drinking should be plentiful during the period of illness, at least 1.5 liters of water per day. Since infectious mononucleosis affects the liver, nutrition should be sparing (adhere to another ½-1 year after recovery).

The child's diet should not contain fatty, fried, smoked foods and sweets. Exclude legumes, garlic, onions. Minimize the consumption of sour cream, butter, cheeses.

Food should be light and rich in vitamins. The menu should contain:

• porridge;
• dairy products;
• a fish;
• fresh fruits and vegetables.

Prognosis and possible complications of the disease

In most cases, the prognosis for infectious mononucleosis is favorable. The main condition for eliminating complications is to monitor blood changes so as not to miss leukemia and other complications. The child's condition must be closely monitored until complete recovery.

Within a month, the lymph nodes return to their normal size, the sore throat disappears in 1-2 weeks. For a long time after recovery, the child remains weak, drowsy, and gets tired quickly. Therefore, for another ½-1 year, he must undergo dispensary observation, check the composition of the blood.

Complications with mononucleosis are rare. It can be:

• ruptured spleen (1 in 1000);
• pneumonia;
• meningoencephalitis;
• jaundice.

Infectious mononucleosis in children, like most viral diseases, has no specific treatment. Therefore, it is important to timely detect the disease and follow all the doctor's prescriptions to accelerate the child's recovery. In order for the body to quickly cope with any viral infection, it is necessary to strengthen immunity from an early age, to monitor proper nutrition and lifestyle.