Mononucleosis: symptoms, treatment, photos in children and adults
Infectious mononucleosis is among the diseases that develop in children. It is dangerous for its severe and numerous complications. What is mononucleosis? How is the disease manifested and diagnosed? Why does it arise? How to treat the pathological process and prevent its occurrence? We will understand together.
What is mononucleosis and how is it dangerous for children?
Infectious mononucleosis is a viral disease that can occur in a chronic (more often) or acute (rarely) form. In the latter case, the disease is accompanied by an enlarged spleen and liver, pathological changes in leukocytes. The acute form is dangerous due to the risk of severe consequences in children and adults. At risk of infection by the Epstein-Barr virus, which is the cause of the disease, include children under 10 years of age.
In infants and children under 3 years of age, it is less common, since pathogens mainly “circulate” in closed children's groups (for example, in schools). In girls, the disease in atypical form is twice as rarely diagnosed as in boys.
Acute infectious mononucleosis rarely develops in people over 35 years old, but they may well act as carriers of the virus - a person is contagious and unaware of it.
Causes of infection
Infection occurs upon contact of the child with the carrier of the virus. At the same time, the overwhelming majority of carriers who can excrete pathogenic microorganisms with saliva and infect others do not themselves notice any symptoms of the disease, that is, they are its carriers. According to research data, 20% of the total adult population and 25% of children are carriers of mononucleosis.
The virus can be transmitted in the following ways:
- vertical - during pregnancy, a woman who has had infectious mononucleosis can transmit the virus to the fetus,
- parenteral - during the transfusion of donor blood,
- contact - through saliva (for example, with a kiss),
- airborne - when a person sneezes or coughs, he spreads the virus in the air around him.
The duration of the incubation period in children
How long the incubation period lasts depends on the individual characteristics of the organism of the small patient and the state of his immune system. If the disease progresses rapidly, the first symptoms will be noticeable after 5 days from the moment of infection. In some cases, the incubation period extends to two weeks.
According to research data, by the age of five, the Epstein-Barr virus infects 50% of children. However, symptoms in an acute, atypical form are manifested only in one person infected out of 1000. In the remaining cases, the disease is chronic in nature and is characterized by the absence of severe symptoms. For this reason, infectious mononucleosis is considered a rare disease.
Symptoms of mononucleosis in a child
If the child develops an infectious mononucleosis in an acute form, then the symptoms will include a complex of signs of intoxication of an organism of viral origin. With the further development of the disease, symptoms of the pharynx and internal organs will appear (as the virus spreads in the patient’s blood). Visually see the visible signs of mononucleosis can be in the photo to the article.
Rash with mononucleosis
The main symptoms of mononucleosis in children are:
- body rash,
- high temperature
- general signs of intoxication - headaches, weakness, fatigue, appetite disturbances, chills,
- throat changes,
- significant increase in the posterior cervical lymph nodes - they reach the size of a chicken egg, but remain painless,
- side pain
- enlarged spleen
Most often, their clusters are localized in the back, abdomen, as well as on the face and limbs of the patient. Symptomatic treatment of rash with mononucleosis is not required - as the patient recovers, it goes away by itself. It should be remembered that the rash when infected with Epstein-Barr virus does not itch. If itching appears, then it is a symptom of an allergic reaction, not of mononucleosis.
Increased body temperature is one of the main characteristic signs of the development of mononucleosis. At the earliest stages we are talking about subfebrile temperature, however, it quickly rises to 38-40 degrees and can hold for several days. If the temperature has risen above 39.5 degrees, this is considered as a direct indication for the hospitalization of the patient.
A few days later, the fever drops to 37-37.5 degrees (this temperature lasts a long time - for several weeks), then the characteristic clinical picture of mononucleosis begins to take shape.
Throat lesions in mononucleosis look like symptoms of purulent tonsillitis or pharyngitis. The patient complains of sore throat, including during swallowing, the mucous membranes of the tonsils and palatine arches redden, there is redness of the posterior pharyngeal wall. Symptomatology almost always manifests itself in parallel with fever and feverish states.
Throat Lesions with Mononucleosis
In order to identify infectious mononucleosis, the doctor will need to carry out a whole range of activities for the examination of a small patient. Also shown is the differential diagnosis of pathologies with similar symptoms. This is a prerequisite, the implementation of which helps to form an effective and safe treatment strategy for the child.
The main methods of diagnosis of mononucleosis include:
- ultrasound examination of the abdominal organs - to assess the state of the spleen and liver, to establish the fact and the extent of their increase,
- PCR diagnostics - in addition to the patient’s blood, salivary secretions or discharge from the pharynx / nose can act as biological material for research,
- serological blood tests (detection of antibodies to the virus) allow differentiation of mononucleosis from other pathologies, as well as establish the phase of the disease,
- biochemical blood test - if liver cells are affected by Epstein-Barr virus, an increased level of bilirubin, hepatic fractions,
- A clinical blood test - 3 signs indicate the development of mononucleosis: the presence of atypical mononuclears (10% or more), an increased content of lymphocytes and leukocytes.
Features of treatment
Specific therapy shown in the development of the acute form of infectious mononucleosis does not exist. The treatment strategy of a particular patient is determined by the physician, based on the individual characteristics of the organism, the stage and severity of the course of the disease. Usually prescribed treatment aimed at eliminating unpleasant symptoms.
If the pathology proceeds in a mild form, then the home treatment is indicated to the child, it should include the following set of procedures:
- taking vitamins
- drink plenty of water
Therapeutic methods are determined individually based on the results of tests and other examinations.
What medications are shown in treating the disease? To eliminate the Epstein-Barr virus in children and adults, drugs of similar properties are used. In the selection of drugs should be considered cases of individual intolerance and age restrictions.
As a rule, the following drugs are prescribed for mononucleosis:
- antipyretic (ibuprofen, paracetamol),
- vitamin complexes,
- local antiseptics
- antibiotics (metronidazole) - penicillin group agents are contraindicated,
- Prednisolone is recommended for severe hypertoxic mononucleosis.
The development of infectious mononucleosis is accompanied by damage to the liver, so the child is required to follow a special diet. Smoked foods, sweet pastries, pickled foods, pickles, animal fats, hard-boiled or fried eggs, legumes, fatty fish should be excluded from the menu.
The list of products allowed during the treatment period includes:
- fresh sour cottage cheese,
- low fat yogurt,
- non-spicy low-fat cheese
- steam pudding
- low-fat milk in the composition of ready meals,
- steam omelette from the proteins of two chicken eggs,
- soups: mucous rice or oatmeal, vegetarian, vegetable broth,
- low-fat boiled fish,
- chopped or mashed veal, chicken, rabbit, cooked in water or steamed,
- porridges on water from buckwheat, rice, semolina and oatmeal, casseroles, puddings and souffles from the listed cereals,
- wheat crackers,
- dried bread
Before applying any popular recipes for the treatment of mononucleosis in a child, you should always consult with your doctor. Traditional medicine is not a full-fledged replacement of prescribed medications. Home remedies can be used as an aid in the complex therapy. They help alleviate the condition of the little patient and speed up the process of his recovery.
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Symptoms of Infectious Mononucleosis
According to experts, the disease in 40 percent of cases develops in the same way as SARS. It is not by chance that the disease was named: "mononuclear", "monocytic", "mononucleosis angina".
A great professionalism is required from the attending physician in order to make the correct verdict on the so-called precursors of the disease (low-grade fever, general malaise).
After 2-3 days, the initial stage is completed, the first signs are complemented by symptoms typical of mononucleosis. They usually develop amid fever caused by intense fever.
How long does the temperature hold? About a week the thermometer can show the number 39.
During this period, the patient is likely to diagnose cytomegalovirus mononucleosis or mononucleosis-like syndrome caused by cytomegalovirus (the cause of mononucleosis is also herpesvirus, but another is Epstein-Barr virus, about what it is and how it is transmitted, we told here), therefore when determining accurate diagnosis doctors usually rely on laboratory data. About what is a CMV infection (cytomegalovirus) read here.
In addition to high temperature, the following manifestations are characteristic of infectious mononucleosis:
- sore throat, pain when swallowing,
- "Island" light gray patina on the tonsils,
- runny nose, cough,
- increased tearing,
- polyadenitis - multiple increase and soreness (with palpation) of lymph nodes,
- rash on the body (in 15 percent of cases)
- an enlarged spleen (about half the cases),
- an increase in the size of the liver.
About the causative agent and the symptom complex of infectious mononucleosis the following video:
Photo of throat and body rash
The severity classifies the following types of diseases:
- easy - temperature of 38 degrees for no longer than five days, an increase in only the cervical lymph nodes, recovery in 2 weeks,
- moderate severity - a temperature of 38.5 degrees for 8 days, lymph nodes, increasing as if along the chain, reach intra-abdominal, a significant increase in the liver, recovery - in 3-4 weeks,
- severe - fever, temperature above 39.5 degrees for more than a week, a significant increase in tonsils, which almost completely cover the lumen of the pharynx, the lymph nodes are palpable in whole groups, the liver is enlarged, the duration of the disease is at least a month, the patient's condition is worsened by various complications.
There are also 2 types of the disease:
- typical mononucleosis (with “classic” symptoms),
- atypical (characteristic symptoms erased, diagnosis is extremely difficult).
According to how long the disease lasts, mononucleosis is characterized as:
- sharp - no longer than 3 months,
- protracted - 3-6 months,
- chronic - 0.5 years.
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Treatment of mononucleosis in children and adults
Children and adult mononucleosis are treated almost equally. This is usually done by an infectious disease doctor.
The standard of treatment is usually not a dogma, since a 100% effective antiviral drug to help defeat the Epstein-Barr virus has not yet been created. On the symptoms and methods of treatment of the Epstein-Barr virus, we have a separate article.
Treatment is usually carried out on an outpatient basis, the patient remains at home, and only in the most severe cases have to lie in the hospital.
The disease is treated with the help of drugs that help in a complex to cope with all the problems of the patient - to suppress the activity of the virus, bring down the high temperature, protect the liver (for this purpose, drugs are used hepatoprotectors).
Among the prescribed drugs:
- antipyretic (Paracetomol, Ibuprofen),
- Antiviral (Groprinosin),
- anti-inflammatory and anti-allergic (Prednisolone, Dexamethasone),
- nasal drops for easier breathing (Xylometazoline, Polydex),
- strengthening immunity (Viferon, Imudon, Tsikloferon, Izoprinozin),
- antibiotics in case other diseases join the main diagnosis, for example, pneumonia (Vilprafen, Klacid, Zinnat),
- to maintain the functions of the liver (Supraks, Ceftriaxone),
- if you have problems with the digestive system, pancreas (Creon 1000).
Self-medication in the case of mononucleosis is unacceptable, since many drugs have contraindications for their use for this particular category of patients - for example, the antibiotics Flemoxin Soluteb and Amoxiclav (provokes the formation of a rash).
Acyclovir (Acyclostad), despite its good anti-herpes reputation, is ineffective in the case of mononucleosis.
The use of folk remedies
With the help of folk remedies, it is possible to improve the condition of the patient - relieve fever, inflammation, soothe irritated throat.
Here are some healing plants recommended to use:
- Astragalus root - tincture cooked in a thermos has antiviral properties, it is drunk three times a day in a couple of tablespoons,
- Echinacea - has antimicrobial properties, supports the immune system, is used in the form of tea,
- calamus root - an infusion helps to solve the problem of difficulty breathing, drink 5-7 times a day for a dessert spoon.
Often plants are used in the form of fees. For example: birch buds + dandelion root + clover flowers + alder buds + Levze root + wormwood stem.
Diet and proper nutrition
This disease is characterized by metabolic disorders. Properly organized nutrition helps to bring it back to normal.
In addition, it is very important for patients to eat fortified foods, and vitamins A, C, B, P are especially needed for the body struggling with an infection.
If a patient with a diagnosis of infectious mononucleosis is in the hospital, he is assigned a "table number 5" diet.
We give a list of dishes used in this diet, which will help the relatives of the patient, who is treated at home, to form their sample menu for the week.
Breakfast: porridge (from flakes "Hercules"), scrambled eggs (steamed, without milk), herbal rosehip tea.
Small snack: carrot soufflé.
Lunch: vegetable soup with rice, a piece of boiled turkey with a side dish of grated boiled beets, compote of dried fruits.
Lunch: 100-gram portion of low-fat cottage cheese and baked apple.
Dinner: steamed fish (for example, hake) with vegetable (zucchini or broccoli) puree, fruit tea (you can - sea buckthorn).
The latest snack: a glass of bifidokephir.
What soups to cook for the patient during the week? Here are a few options:
- chicken noodles,
- soup with meatballs,
- vegetable (with cauliflower, carrots),
- buckwheat with vegetables.
Recommended main dishes:
- steamed patties (from meat, poultry, fish),
- cutlets stuffed with carrots and chicken yolk,
- steam fish with vegetables from the slow cooker,
- ground beef casserole (boiled meat is used) and pasta or cereals.
Kashi cooks for the week are different: buckwheat, barley, oatmeal, wheat, millet, semolina. If the porridge is milky, neither salt nor sugar can be put into it.
From drinks experts recommend: kissel, compotes, herbal teas, weak tea. Bread to the patient can be eaten both white and black, the main thing is that he was not fresh. Cookies are also possible, but only incomparable.
How to treat women during pregnancy
Epstein-Barr virus is dangerous for pregnant women, it can cause infection of the fetus, resulting in a newborn will form a predisposition to diseases of the lymphatic and nervous system, organs of sight.
What should a woman do if she gets sick? Seek help from a doctor, do not self-medicate.
If the condition requires quick solutions, you can take painkillers and antipyretics, and in the pediatric dosage. Also needed bed rest.
What medications will the doctor suggest? The choice is not very large, since the funds should be as safe as possible for the unborn child. It:
- Human interferon (candles)
- Troxevasin (capsules),
- folic acid,
- vitamin complexes,
- calcium supplements.
Approximately the same treatment - in a nursing mother, and in addition - strict precautions against the child, so that the infant does not have problems like the mother.
What it is?
For a long time, especially in Russian medical practice, infectious mononucleosis was called Filatov disease. This zemstvo doctor drew attention to the fact that many babies have similar clinical signs: an increase in peripheral lymph nodes, frequent headaches or dizziness, pain in the joints and muscles when walking. Filatov called this condition glandular fever.
Currently, science has stepped far forward. With the help of various diagnostic tests and high-precision devices, scientists obtained up-to-date information about what causes the disease. In the medical world, it was decided to change the name of the disease. Now it is simply called infectious mononucleosis.
There is a credible hypothesis that the disease has a viral cause. To the development of this pathology lead viruses. This leads to the fact that a person with infectious mononucleosis is potentially dangerous and infectious to others. During the entire acute period of the disease, it can infect other people with the infection.
Most often, this infectious pathology occurs in people of young age, as well as in children. Scientists note that sporadic cases can occur. Large and massive outbreaks of infectious mononucleosis are extremely rare. Basically, all the epidemics associated with this disease occur in the cold season. The peak of the incidence is autumn.
Usually, viruses that get on the mucous membranes settle in the body and trigger the inflammatory process. Their favorite primary localization is epithelial cells lining the outer surface of the nasal passages and oral cavity. Over time, the pathogenic microbes penetrate the lymph and rapidly spread throughout the body along with the bloodstream.
In a child, all the processes in the body proceed swiftly. This feature is due to the characteristics of the physiological structure of the child's body.
Fast processes need a baby for active growth and development. The blood flow in babies is quite rapid. Pathogenic viruses, getting into the body, usually within a few hours or days spread and activate the inflammatory infectious process.
Infectious mononucleosis can be dangerous. The disease is characterized by the development of remote complications or adverse effects. Some babies, especially those who are frequently ill or suffer from immunodeficiency diseases, have a risk of a more severe course. Predict how the disease will develop in a particular child will not work. To prevent potential long-term effects of the disease, the baby should be closely monitored throughout the acute period of the disease and during recovery.
The development of infectious mononucleosis is usually gradual. One clinical stage successively replaces the other. Usually such a course occurs in the majority of sick babies. Only in some cases, possible rapid acute progression of the disease with the development of numerous complications.
The very first period of the disease - the initial. On average, it lasts 1-1.5 months. Most clinical cases are accompanied by fever up to 39.5-40 degrees. The severity of the condition causes the appearance of a headache. It can be of varying intensity: from moderate to unbearable. Against the background of high fever and headache, the child has severe nausea and even single vomiting occurs.
In the acute period of the disease, the baby feels extremely bad. He has a strong pain in the joints and muscle weakness. He gets tired very quickly. Even the usual everyday activities for a kid lead to his quick fatigue. The child eats badly, refuses his most favorite delicacies. Aggravating loss of appetite and the presence of severe nausea.
These signs are easy to identify and self. Their appearance causes mommies a real shock. Do not panic! If adverse symptoms of the disease appear, be sure to call a doctor. Do not go with the child to the clinic. The difficult condition of the baby requires the consultation of a specialist at home.
In some cases, children have less pronounced symptoms. In this case, the body temperature does not increase so rapidly. It usually rises to subfebrile or febrile numbers in a few days. The characteristic symptoms during this period are: general malaise, severe weakness, nasal congestion and disturbed nasal breathing, eyelid edema, and also some puffiness and puffiness of the face.
In 10% of babies, the disease can begin with the appearance of three characteristic symptoms at the same time. These include: fever to febrile numbers, lymph nodes and signs of acute tonsillitis. This course is usually quite heavy.
The duration of the initial period of the disease is usually from 4 days to a week.
The next stage of the disease is peak time. Typically, the peak occurs within a week after the onset of the first adverse symptoms. The general health of the child by this time is deteriorating. He also has a fever. A very specific feature at this time is mononucleosis angina.
The mononuclear form of acute tonsillitis (sore throat) is quite difficult. It is accompanied by the appearance of numerous symptoms in the throat. Typically, angina occurs in catarrhal form. Tonsils become bright red, hyperemic. In some cases, they appear bloom. It is usually white or with a gray tint. Often the overlays on the tonsils are quite loose and are relatively well removed using a spatula or a regular spoon.
The duration of acute tonsillitis in infectious mononucleosis usually does not exceed 10-14 days. Over time, the tonsils are cleared of plaque and all the unfavorable signs of illness disappear.
During the height of the disease is often also accompanied by severe symptoms of intoxication. The child remains severe or mild headache, decreased appetite, disturbed sleep. Sick kid becomes more capricious. The child's sleep duration is disturbed. Typically, sick babies sleep longer during the daytime, and at night they experience significant problems with falling asleep.
One of the characteristic signs of the height of the disease is the appearance of symptoms of lymphadenopathy. Typically, the immediate peripheral lymphatic collectors are involved in this inflammatory process. With this disease, it is the cervical lymph nodes. They increase in size several times. Sometimes inflamed lymph nodes reach the size of a walnut.
When feeling, they are quite painful and mobile. Any movements of the head and neck lead to increased pain. Overheating of the lymph nodes in the acute period of the disease is unacceptable! The imposition of warming compresses on the neck can only aggravate the course of the disease and contribute to the development of dangerous complications.
Cervical lymphadenopathy in infectious mononucleosis is usually symmetrical. It is easy to notice from the side with the naked eye. Changing the look of the baby. Severe edema of the subcutaneous fatty tissue surrounding the inflamed lymph nodes leads to the development of a “bull neck” in a child. This symptom is associated with a violation of the overall configuration of the neck and is unfavorable.
By the end of 12-14 days after the onset of the disease, the child appears clinical signs of involvement in the inflammatory process of the spleen. This is manifested by an increase in its size. Doctors call this condition splenomegaly. In an uncomplicated course of the disease, the size of the spleen is fully normal by the end of the third week since the onset of the disease.
Also, by the end of the second week, the baby has signs of liver damage. Hepatitis is manifested by an increase in the size of this organ. Visually, this is manifested by the appearance of yellowing of the skin - jaundice develops. Some babies also turn yellow sclera eyes. Usually this symptom is transient and passes by the end of the peak of the disease.
For 5-7 days after the onset of the disease, children have another characteristic sign - a rash. It occurs in about 6% of cases. Rash - maculopapular. There is no clear localization of the appearance of skin rashes. They can appear on almost the whole body. Bulk items do not itch and practically do not bring the child any anxiety.
Usually the rash goes away on its own. Skin elements disappear consistently and leave no trace of hyper- or depigmentation on the skin. After the rash disappears, the baby’s skin becomes familiar physiological color and is not changed. Residual peeling on the skin also does not remain. By the end of the period of height, the baby begins to feel much better.
By the end of the second week of the disease, his nasal congestion disappears and his breathing normalizes, his body temperature rises, and his face becomes swollen. On average, the total duration of this period of the disease is 2-3 weeks. This time may be different and depends on the initial state of the baby.
Toddlers with multiple chronic diseases of internal organs, suffer a peak period much worse. They can have it for more than a month.
The final period of the disease - convalescence. This time is characterized by the complete termination of the disease and the disappearance of all adverse symptoms. In babies, body temperature returns to normal, plaque on the tonsils completely disappears, and normal size of the cervical lymph nodes is restored. The child feels much better at this time: appetite returns and weakness decreases. Baby begins to recover.
Usually, for the complete disappearance of all the symptoms takes time. So, the period of convalescence in babies is usually 3-4 weeks. After this comes recovery. Some children who have had infectious mononucleosis may have residual symptoms for a longer time. During this period it is very important to exercise regular medical monitoring of the baby’s well-being so that the disease does not become protracted.
When the first signs of the disease appear, be sure to show the baby to the doctor. The doctor will conduct the necessary clinical examination, during which he will inspect the sore neck, feel the lymph nodes, and be able to determine the size of the liver and spleen. After such an examination, the pediatrician usually prescribes several additional laboratory tests to further clarify the diagnosis.
To establish the source of the disease, doctors resort to blood testing to determine the specific immunoglobulins of class M and G against the virus-Barr virus. This simple test allows you to distinguish mononucleosis tonsillitis from other viral or bacterial tonsillitis. This analysis is highly sensitive and in most cases gives a real idea of whether the virus is in the blood.
To establish the functional abnormalities that occur in the internal organs, a biochemical blood test is required. If a child has signs of mononucleosis hepatitis, then hepatic transaminases and bilirubin levels will be increased in the blood. Complete blood count will help identify all abnormalities that occur in viral diseases. The severity of these changes may be different.
In the general analysis of blood, the total number of leukocytes, monocytes, and lymphocytes increases. Accelerated ESR indicates a pronounced inflammatory process. A change in leukocyte formula indicates the presence of a viral infection in the body. At different stages of the development of the disease in the general analysis of the blood, various pathological changes appear that change with the course of the disease.
A characteristic feature is the appearance of atypical mononuclears in the analysis of specific cells. They have a large cytoplasm inside. If their number exceeds 10%, then this indicates the presence of the disease. Usually, these cells do not appear immediately after the onset of the disease, but after a few days or even weeks. In size, they resemble large monocytes with a modified structure.
Laboratory tests allow differential diagnosis to be carried out fairly accurately. Infectious mononucleosis can be masked as diphtheria, various types of acute tonsillitis, acute leukemia, Hodgkin's disease and other dangerous childhood diseases. In some difficult clinical cases, a whole complex of diagnostic measures is required, including the performance of various laboratory tests.
In order to accurately determine the size of the internal organs used ultrasound. Using a special sensor, a specialist studies the surface of the organs and determines their parameters. Ultrasound diagnosis helps to identify all changes that occur in the liver and spleen during the development of infectious mononucleosis. The method is quite accurate and informative.
The undoubted plus of the research is the safety and absence of any painful sensations in the child during its conduct.
Consequences and complications
The course of the disease may not always be easy. In some cases, there are health hazards. They can significantly impair the health of the child and lead to a deterioration in his condition. Failure to provide timely assistance such consequences of infectious mononucleosis have a significant impact on the quality of life of the baby in the future.
The disease can be dangerous by the development of the following negative complications:
- Rupture of the spleen. Pretty rare option. It occurs in no more than 1% of cases. A strong splenomegaly causes the outer capsule of the spleen to rupture and an organ rupture occurs. If a surgical operation is not performed on time, then a comatose state and even death may occur.
- Anemic condition. Such hemorrhagic anemia is associated with a disruption of the spleen. There are also signs of immune thrombocytopenia in the blood. This condition is caused by the impaired work of the spleen, as a blood-forming organ.
- Neurological pathologies. These include: various clinical variants of meningitis and encephalitis, acute psychotic states, sudden cerebellar syndrome, paresis of peripheral nerve trunks, Guillain-Barre syndrome (polyneuritis).
Infectious mononucleosis - what is it?
the onset of the disease may be similar to a cold
First of all, this disease has several other names. If you hear terms such as “glandular fever,” “Filatov's disease,” or “monocytic sore throat,” then know that we are talking about mononucleosis.
If the name "mononucleosis" is deciphered, this term means an increase in the content of mononuclear or mononuclear cells in the blood. Such cells include special types of white blood cells, or white blood cells, which perform a protective function. These are monocytes and lymphocytes. Their content in the blood is not just increased with mononucleosis: they become altered, or atypical - it is easy to detect when studying a stained blood smear under a microscope.
Infectious mononucleosis is a viral disease. Since it is caused by a virus, and not by a bacterium, it must immediately be said that the use of any antibiotics is completely meaningless. But this is often done because the disease is often confused with a sore throat.
After all, the transmission mechanism of mononucleosis is aerosol, that is, airborne, and the disease itself affects lymphoid tissue: there is pharyngitis and tonsillitis (angina), hepatosplenomegaly appears, or an increase in the liver and spleen, and the blood lymphocyte and monocyte count which become atypical.
Who is guilty?
It causes infectious mononucleosis Epstein-Barr virus, which belongs to the herpes viruses. In total, there are almost a dozen families of herpes viruses and even more of their types, but lymphocytes are so sensitive to this type of virus, because on their membrane they have receptors for the envelope protein of this virus.
The virus is unstable in the environment, and quickly dies with any available methods of disinfection, including ultraviolet radiation.
A characteristic feature of this virus is a special effect on cells. If ordinary viruses of the same herpes and chickenpox exhibit a pronounced cytopathic effect (that is, leading to cell death), then EBV (Epstein-Barr virus) does not kill the cells, but causes their proliferation, that is, active growth. This fact lies in the development of the clinical picture of mononucleosis.
Epidemiology and ways of infection
Since only people are infected with infectious mononucleosis, a sick person can infect a healthy person, and not only a bright, but also an erased form of the disease, as well as an asymptomatic carrier of the virus. It is due to healthy carriers that the "virus cycle" is maintained in nature.
In most cases of the disease, the infection is transmitted by airborne droplets: when talking, crying, crying, sneezing and coughing. But there are other ways in which infected saliva and body fluids can enter the body:
- kisses, sexual way,
- through toys, especially those who have been in the child’s mouth - the virus carrier,
- through blood transfusion, if donors are carriers of the virus.
Susceptibility to infectious mononucleosis is universal. This may seem incredible, but most healthy people are infected with this virus, and are carriers. In the underdeveloped countries, where there is a big overcrowding of the population, this occurs in babies, and in developed countries - in adolescence and youth.
Upon reaching 30 - 40 years of age, the majority of the population is infected. It is known that men suffer from infectious mononucleosis more often, and people over 40 suffer very rarely: infectious mononucleosis is a disease of a young age. True, there is one exception: if a patient is sick with HIV infection, then at any age he may not only have mononucleosis, but also repeat. How does this disease develop?
Infectious mononucleosis in adults and children begins with the fact that infected saliva enters the oropharynx, and there the virus replicates, that is, its primary reproduction occurs. It is the lymphocytes that are the object of an attack of the virus, and they quickly become infected. After that, they begin to transform into plasma cells, and synthesize various and unnecessary antibodies, for example, hemagglutinins, which can glue foreign blood cells.
A complex cascade of activation and suppression of various parts of the immune system is launched, and this leads to the fact that young and immature B lymphocytes accumulate in the blood, which are called “atypical mononuclear cells”. Despite the fact that they are their own cells, even if they are immature, the body begins to destroy them, because they contain viruses.
As a result, the body weakens, trying to destroy a large number of its own cells, and this contributes to the accession of a microbial and bacterial infection, since the body and its immunity are "occupied with another matter."
All this is manifested by a generalized process in the lymphoid tissue. The proliferation of immunity cells causes hypertrophy of all regional lymph nodes, the spleen and liver are enlarged, and in the case of severe disease, there may be necrosis in the lymphoid tissue and the appearance of various infiltrates in organs and tissues.
On the diagnosis of mononucleosis
Infectious mononucleosis is a disease with a characteristic clinical picture, and it is always possible to identify atypical mononuclear cells in peripheral blood. This is a pathognomonic symptom, just like fever, swollen lymph nodes, hepatosplenomegaly and tonsillitis combined.
Additional research methods are:
- Reaction Hoff - Bauer (positive in 90% of patients). Based on the detection of hemagglutinating antibodies, with an increase in their titer 4 or more times,
- ELISA methods. Allows you to identify marker antibodies that confirm the presence of virus antigens (against capsid and nuclear antigens),
- PCR detection of virus in blood and saliva. It is often used in newborns, since it is difficult to focus on the immune response, since the immunity is not yet formed.
Treatment of infectious mononucleosis, drugs
Uncomplicated and mild forms of infectious mononucleosis are treated at home by both children and adults. Patients with jaundice are hospitalized, a significant enlargement of the liver and spleen, an unclear diagnosis. The principles of treatment of infectious mononucleosis are:
- "Liver" table number 5. The diet requires you to abandon spicy, smoked, fatty and fried foods, to facilitate the work of the liver,
- Shows a half-bed mode, a rich, vitamin drink,
- It is necessary to rinse the oropharynx with antiseptic solutions ("Miramistin", "Chlorhexidine" "," Chlorophyllipt "), in order to avoid the addition of a secondary infection,
- Showing antipyretic agents from the group of NSAIDs.
Attention! How to treat infectious mononucleosis in children, and what drugs can not be used? All parents should remember that taking aspirin in any form and dose is strictly forbidden for children until they reach the age of at least 12 to 13 years, since a serious complication can develop - Ray's syndrome. Only paracetamol and ibuprofen are used as antipyretic drugs.
- Antiviral therapy: interferons and their inductors. "Neovir", cycloferon, acyclovir. They are used, although their effectiveness has been proven by studying only in the laboratory,
- Antibiotics are prescribed for the appearance of suppuration on the tonsils, other purulent - necrotic complications. Fluoroquinolones are used more often than others, but ampicillin may contribute to the appearance of a rash in most patients,
- If the rupture of the spleen is suspected, the patient should be urgently operated, for health reasons. And always the attending physician should pay attention to patients who are treated at home, that with an increase in jaundice, the appearance of acute pain in the left side, severe weakness, decrease in pressure, you need to urgently call an ambulance and hospitalize the patient in a surgical hospital.
How long to treat infectious mononucleosis? It is known that in 80% of cases a significant improvement occurs between 2 and 3 weeks of the disease, therefore, active treatment should be carried out for at least 14 days from the moment of the first signs of the disease.
But, even after improving health, it is necessary to limit the motor mode and sports for 1 - 2 months after discharge. This is necessary because the spleen is enlarged for a long time, and there is a significant risk of its rupture.
In the event that severe jaundice was diagnosed, the diet should be followed within 6 months after recovery.
Effects of mononucleosis
After infectious mononucleosis remains stable immunity. Repeated cases of the disease is not observed. As the rarest of exceptions, mononucleosis can be fatal, but it can be caused by complications that have little to do with the development of the virus in the body: it may be obstruction and swelling of the respiratory tract, bleeding due to rupture of the liver or spleen, or encephalitis.
In conclusion, VEB is not at all as simple as it seems: while remaining persistent in the body for life, he often tries to “demonstrate his abilities” in cell proliferation in other ways. It causes Berkit's lymphoma, it is considered a possible cause of certain carcinomas, as its oncogenicity, or the ability to "incline" the body to cancer, has been proven.
Also, its role in the rapid course of HIV infection is not excluded. Of particular caution is the fact that the EBV genetic material is firmly integrated in the affected cells with the human genome.
Currently studying this phenomenon, and it is possible that the Epstein-Barr virus will give a clue to the creation of a vaccine against cancer and other malignant tumors.
Causative agents and forms of infectious mononucleosis
The causative agents of mononucleosis are herpes viruses of various types. Most often, it is the Epstein-Barr virus, named after the scientists Michael Epstein and Yvonne Barr who discovered it. Infectious mononucleosis of cytomegalovirus origin is also found. In rare cases, pathogens can be other types of herpes viruses. 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 in childhood has had this disease.
The virus begins to develop in the oral mucosa, affecting the tonsils and pharynx. Through blood and lymph, it enters the liver, spleen, heart muscles, lymph nodes. Usually the disease is acute. Complications are extremely rare - in the case when the secondary pathogenic microflora is activated as a result of a weakened immunity. This is manifested in inflammatory diseases of the lungs (pneumonia), middle ear, maxillary sinuses and other organs.
The incubation period can be 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 a chronic form, in which the lymph nodes are constantly enlarged, damage to the heart, brain, nerve centers is possible. In this case, the child has psychosis, facial disorders.
After recovery, the viruses that cause infectious mononucleosis remain in the body forever, so the patient is the carrier and source of infection. However, the recurrence of the person himself occurs extremely rarely, in the event that for some reason he has a sharp weakening of the immune system.
Note: Due to the fact that the virus carrier with mononucleosis remains lifelong, it does not make sense to isolate a child from other people after he has signs of indisposition. Healthy people can be protected from infection only by strengthening the immune forces.
Forms of the disease
There are the following forms:
- Typical - with pronounced symptoms, such as fever, sore throat, enlarged liver and spleen, the presence of virocytes in the blood (the so-called atypical mononuclear cells - a type of white blood cell).
- Atypical. In this form of the disease, any of the characteristic symptoms of infectious mononucleosis in a child is completely absent (for example, no virocytes were found in the blood) or implicit, erased symptoms. Sometimes there are pronounced damage to the heart, nervous system, lungs, kidneys (the so-called visceral organ damage).
Depending on the severity of the disease, the increase in lymph nodes, liver and spleen, the number of mononuclear cells in the blood of a typical mononucleosis is divided into easy flowing, moderate and heavy.
The following forms of mononucleosis can be distinguished:
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 become infected when you kiss (a common cause of infection of adolescents), when using dishes with a sick person. In the children's team, children play with common toys, often confuse their water bottle or nipple with a stranger. The virus can be on a towel, bedding, clothes of the patient. When sneezing and coughing, mononucleosis pathogens enter the surrounding air with droplets of saliva.
In close contact are children of preschool and school age, 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 are sick with mononucleosis more often than girls.
The peak in the incidence of children falls in the spring and autumn (outbreaks are possible in the children's institution), as the infection and the spread of viruses contribute to the weakening of the immune system, hypothermia.
A warning: Mononucleosis is a highly contagious disease. If the child has been in contact with the patient, then within 2-3 months the parents should pay special attention to any illness of the baby. If there are no obvious symptoms, it means that the body’s immune system is strong enough. The disease could be mild or infection was avoided.
Symptoms and signs of the disease
The most characteristic signs of infectious mononucleosis in children are:
- Sore throat when swallowing due to inflammation of the pharynx and pathological growth of the tonsils. They appear raid. At the same time from the mouth smells bad.
- Difficulty in nasal breathing due to lesions of the nasal mucosa and the onset of edema. The child snores, cannot breathe with the mouth closed. A runny nose appears.
- Manifestations of general intoxication of the body with the products of the virus. These include aching muscles and bones, a feverish state in which the baby's temperature rises to 38 ° -39 °, chills are observed. Baby sweats heavily. Headache, general weakness.
- The emergence of "chronic fatigue syndrome", which manifests itself even a few months after the illness.
- Inflammation and swollen lymph nodes in 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, there is severe pain ("acute abdomen"), which can mislead the doctor when making a diagnosis.
- Enlarged liver and spleen, jaundice, dark urine. With a strong increase in the spleen, even its rupture occurs.
- 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 in a few days. If an itchy rash appears, it indicates an allergic reaction to any medication (usually an antibiotic).
- Signs of disruption of the central nervous system: dizziness, insomnia.
- Swelling of the face, especially the eyelids.
The child becomes lethargic, tends to lie down, refuses to eat. You may experience symptoms of impaired heart function (rapid heartbeat, noise). After adequate treatment, all these signs disappear without sequela.
Note: As Dr. E. Komarovsky emphasizes, infectious mononucleosis, first of all, is distinguished from angina by the fact that, in addition to sore throat, nasal congestion and runny nose occur. The second hallmark is an enlarged spleen and liver. The third sign is a high content of mononuclear cells in the blood, which is established using laboratory analysis.
Often in young children, the symptoms of mononucleosis are mild, they are not always possible to distinguish from the symptoms of SARS. In babies of the first year of life, mononucleosis produces a runny nose, cough. When breathing, wheezing is heard, there is redness of the throat and inflammation of the tonsils. At this age, a skin rash appears more often than older children.
Up to 3 years of age to diagnose mononucleosis by blood tests is more difficult, since it is not always possible to obtain reliable results of reactions to antigens in a young child.
Most clearly the signs of mononucleosis appear in children aged 6 to 15 years. If only fever is observed, this indicates that the body is successfully fighting infection. Fatigue syndrome persists for 4 months after the remaining symptoms of the disease disappear.
Antibiotics do not act on viruses, so their use is useless, and in some babies they cause an 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 assigned to restore beneficial intestinal microflora (acipol).
When treating used antipyretics (for babies, panadol syrups, ibuprofen). Rinsings with a solution of soda, furatsilina, as well as chamomile, calendula and other herbs are used to relieve inflammation of the throat.
Relief of symptoms of intoxication, elimination of allergic reactions to toxins, prevention of bronchospasm (when the virus spreads to the respiratory organs) are achieved with the help of antihistamines (zyrtek, claritin in the form of drops or tablets).
To restore the functioning of the liver, cholagogic drugs and hepatoprotectors (Essentiale, Kars) are prescribed.
Immunomodulatory and antiviral drugs, such as imudon, cycloferon, anaferon, are used in children to strengthen the immune system. 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 therapeutic diets.
In case of severe laryngeal edema, hormonal preparations are used (prednisone, for example), and if normal breathing is impossible, artificial lung ventilation is performed.
When the spleen ruptures, it is surgically removed (splenectomy is performed).
A warning: It must be remembered that any treatment for this disease should be carried out only as directed by a physician. Self-medication will lead to severe and irreparable complications.
Prevention of Mononucleosis Complications
In order to prevent the development of complications of mononucleosis, the child’s condition is monitored not only during the illness, but also for 1 year after the disappearance of the manifestations. The composition of the blood, the condition of the liver, lungs and other organs is monitored in order to prevent leukemia (damage to the bone marrow), inflammation of the liver, and impaired functioning of the respiratory system.
Считается нормальным, если при инфекционном мононуклеозе в течение 1-2 недель продолжается ангина, лимфоузлы увеличены в течение 1 месяца, сонливость и утомляемость наблюдаются до полугода с момента начала заболевания. Температура 37°-39° держится в течение нескольких первых недель.
Diet for mononucleosis
In this disease, food should be fortified, liquid, high-calorie, but non-fat, in order for the liver to work as much as possible. Soups, porridges, dairy products, boiled lean meat and fish, as well as sweet fruits are included in the diet. It is forbidden to eat spicy, salty and sour foods, garlic and onions.
The patient should consume a lot of fluids (herbal teas, compotes) in order to prevent dehydration, and toxins are eliminated with the urine as soon as possible.
The use of traditional medicine for the treatment of mononucleosis
Such means with the knowledge of the physician, after appropriate examination, are used to alleviate the condition of a child sick with mononucleosis.
To eliminate the 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. Lime tea, lingonberry juice helps relieve headaches and body aches caused by intoxication of the body.
To facilitate the state and speed up recovery, decoctions from plant gatherings are used, for example, from a mixture of rosehip, mint, motherwort, oregano and yarrow, as well as infusions from rowan, hawthorn with the addition of birch leaves, blackberries, cowberries, currants.
Echinacea tea (leaves, flowers or roots) helps to strengthen the immune system to fight microbes and viruses. At 0.5 liters of boiling water is taken 2 tbsp. l raw material and infused for 40 minutes. Give the patient 3 cups a day in the acute period. You can drink this tea and for the prevention of the disease (1 glass per day).
Lemon balm herb has a strong soothing, anti-allergenic, immunomodulatory, antioxidant effect, from which medicinal tea is also prepared, drunk with honey (2-3 cups a day).
Compresses with infusion prepared from birch leaves, willow leaves, currants, pine buds, calendula flowers, chamomile can be applied to swollen lymph nodes. Brew 1 liter of boiling water 5 tbsp. l mixture of dried ingredients, insist for 20 minutes. Compresses apply for 15-20 minutes every other day.
Causes of mononucleosis in children, how the disease is transmitted and proceeds
Infectious mononucleosis is also known under the names of glandular fever Filatov, infectious reactive reticulosis. Most often, children and young people suffer from mononucleosis. There is a disease in the form of sporadic cases, but there may be small epidemic outbreaks of the disease. Signs of mononucleosis in children and adults can occur at any time of the year, but the incidence is highest in the fall.
To date, the causative agent of the disease has not been fully studied. It is believed that the cause of mononucleosis in children is filtered Epstein-Barr virus. The virus is not resistant to environmental factors.
The source of infection is a sick person. Also in the role of a source of infection can be the virus carrier. Mononucleosis in children, like many other infectious diseases, is transmitted by airborne droplets, infection with very close contact of a healthy person with a patient is possible, and the possibility of transmission through the objects of care and toys is not excluded.
As seen in the photo, the causative agent of infectious mononucleosis in children through the mucous membrane lining the nasopharynx, is introduced into the thickness of the mucous membrane, penetrates into the blood and lymph, and then spreads through the body:
The mononucleosis of children proceeds hard: the virus infects reticulohistiocytic tissue - lymph nodes, spleen. The defeat of these organs is accompanied by certain manifestations, from which the characteristic clinical picture of the disease is formed.
How dangerous and how is mononucleosis in children, the consequences of the disease
The duration of the incubation period from 4 to 28 days. Manifesting mononucleosis in children, like many other infectious diseases, is acute: body temperature rises to 38-39 ᵒ C, the child has a feeling of indisposition, headache. Also, the symptoms of mononucleosis in children are sore throat, symptoms of the common cold (nasal congestion, nasal discharge). Body temperature can constantly stay at a high level or at times decrease to normal values.
Pay attention to the photo - a sign of mononucleosis in children is an increase in lymph nodes:
When examining a child, the doctor reveals strongly enlarged posterior cervical and submandibular lymph nodes. The degree of increase is different: the lymph nodes can be from the size of a pea to the size of a walnut. Knots tight to the touch, slightly painful.
Look at the photo - the symptoms of mononucleosis in children may be a slight increase in such groups of lymph nodes, as axillary, inguinal, elbow:
Knots among themselves are not soldered, mobile. An increase in lymph nodes can be observed from the first days of the disease, but they reach the largest size by the third or fourth day. Around the same time, a child develops a sore throat. The latter may be catarral, lacunar, or diphtheritic ulcer. The amygdala located in the nasopharynx also suffers. The tonsil raids can be massive, have a loose-curd consistency and a whitish-yellow color. Simultaneously with an increase in lymph nodes, the liver and spleen (hepatolienal syndrome) are enlarged. Also the symptoms of infectious mononucleosis in children are the yellowness of the skin and the whites of the eyes. In some cases, rashes of a different nature are possible.
The duration of the disease can be up to four weeks, usually 1.5-2 weeks. First, the child's body temperature returns to normal, then manifestations of sore throat, lymphadenitis disappear, then the liver and spleen return to the normal range. In parallel, the general condition of the patient improves.
What is dangerous about mononucleosis in young children? Complications of this infectious disease are rarely observed. Among the possible consequences of mononucleosis in children should be called serous meningitis, pneumonia, nephritis, otitis media, stomatitis.
The prognosis for a child with infectious mononucleosis is favorable. It should be a full recovery.
Here you can see photos of mononucleosis in children at different periods of the disease:
Antiviral drugs and nutrition for children with mononucleosis
The diet of the child on the composition of the products - the usual. However, the nutrition of children suffering from mononucleosis should be sparing, since it is painful for a child to swallow solid food in cases of tonsillitis, the menu consists of liquid and semi-liquid dishes. The diet of a sick child is enriched with foods with which vitamins A and C enter the body, significantly increasing the resistance of the organism to infection.
Having identified the symptoms of mononucleosis, the treatment is prescribed by a doctor. In the febrile period, the child must observe strict bed rest. The room in which the child is located should be regularly aired. Wet cleaning using antiseptics - at least once a day.
There is no specific treatment for mononucleosis in children. Therapy is based on the principles of symptomatic therapy. During the period of increasing body temperature in children with mononucleosis, antipyretic and diabetic drugs are prescribed, it is important to drink plenty of fluids, pain relievers for headaches, and vasoconstrictor drugs for nasal congestion (naphthyzin, galazolin, mezaton, ephedrine, adrenaline). The doctor may prescribe desensitizing agents. As antiviral agents for mononucleosis in children, regular gargling with solutions of baking soda, furatsilina, infusions or decoctions of medicinal plants exhibiting antiseptic and anti-inflammatory effects are shown. Gargle with different means 6-8 times a day. Antibiotics are included in the treatment plan for infectious mononucleosis in children with a severe course of the disease, with a strong inflammatory reaction in the throat (joining a secondary infection). Also, if the child suffers from a disease, hormones may be prescribed.
Care for children with infectious mononucleosis
Before treating infectious mononucleosis in children, it is necessary to consult a doctor. Mom, who cares for a child suffering from this disease, should pay attention to the following recommendations:
- food should be given to a sick child only in liquid or shabby form, it is especially important to follow this recommendation during that period of illness when a child develops a sore throat and when it hurts him to swallow hard coarse food, give all dishes to the child warm, warm, warming the tonsils , suppresses the infection and contributes to the speedy recovery, you need to often include warm cereals in the child's menu.
- When identifying signs of infectious mononucleosis in children, any cold, hot, salty and spicy dishes should be excluded from the menu, crackers, cookies, chips, cornflakes and sticks, etc. should not be given to the child,
- abundant warm drinking is very useful for the child, firstly, warm drinking helps to warm the tonsils and suppress the infection in them, and secondly, when large amounts of fluid enter the body, this organism is cleared of toxins more quickly. A sick child should be given to drink vegetable and fruit juices, tea (black long leaf and herbal), compotes, fruit drinks (cranberry, lingonberry), kissels, an infusion (macerate) of cinnamon rosehip, etc.
- When caring for children with infectious mononucleosis, it is necessary to ensure that the child breathes only with the nose, when breathing through the nose, the air is cleaned in the nasal passages, so the likelihood of adherence to the painful process of secondary infection is reduced, if the child’s nose is stuffed up, it is necessary to remove the mucous membrane shell vasoconstrictor, which will recommend a doctor. Blowing the baby out regularly, so that the accumulations of mucus and crusts do not interfere with free breathing through the nose.
- In the process of how to treat mononucleosis in children, the child should as often as possible gargle with soda solution, salt solutions (common salt solution, natural sea salt solution), mineral waters, infusions and decoctions of medicinal plants that have antimicrobial, antiviral and anti-inflammatory effects. All proposed means for gargling should be warm. Gargle do as often as possible. After each rinse, the child does not eat or drink for 30 minutes so that the agent has time to show its effect.
To date, measures aimed at preventing the disease of infectious mononucleosis have not been developed.
Treatment of infectious mononucleosis in children folk remedies
In the treatment of infectious mononucleosis folk remedies (with the consent of the attending physician, you can use the following recipes phytomedicine.
- Take a warm infusion of flowers and leaves of Hypericum perforatum. Preparation of the infusion: 1 tablespoon of dried, crushed raw materials pour 1 glass of boiling water and leave at room temperature for about 45 minutes, strain through gauze. Infusion has an antiseptic, anti-inflammatory, tonic effect. In addition, when this infusion is taken orally, an antipyretic and diaphoretic effect is achieved. Children 3-5 years old take 2 tablespoons of infusion 3-4 times a day after meals, children 6-10 years old drink 1/4 cup of infusion 3 times a day after meals, older children can drink 1/2 cup means 3 times a day after meals,
- regularly do gargling with warm extract of chamomile flowers. Preparation of infusion: 1 tablespoon of dried flowers, crushed to a state of powder, pour 1 glass of boiling water and insist, tightly covered with a lid, about half an hour, strain through 1-2 layers of gauze, squeeze out the remaining raw materials. To gargle the child's throat 5-6 times a day, alternating with other means that have an antiseptic and anti-inflammatory effect. Among such remedies, there is an infusion of flowers and leaves of Hypericum perforatum, an infusion of peppermint grass, an infusion of Origanum herb, an infusion of calendula flowers, a decoction of globular eucalyptus leaves, an infusion of herb balissa, a decoction of birch leaves (hanging), etc.
- In cases of mononucleosis, children should regularly gargle with a warm extract of sage leaves. Preparation of infusion: 1 tablespoon of dried, carefully crushed leaves pour 1 glass of boiling water and infuse infused in enamelware at room temperature for about 20 minutes, strain the infusion through 1-2 layers of gauze, squeeze the remaining raw material through the same gauze. To gargle the child's throat, combining with other means, several times during the day. This infusion has some disinfecting, anti-inflammatory and analgesic effects,
- do the rinsing throat warm extract of flowers and leaves of Hypericum perforatum. Preparation of infusion: 1 tablespoon of dried raw materials, pounded with a pestle in a mortar, pour into pre-warmed dishes, pour 1 cup of boiling water and leave, covered tightly with a lid, for a quarter of an hour, strain after 1-2 layers of gauze, squeeze out the remaining raw materials, soaked water, through the same gauze. To restore children after mononucleosis, you need to gargle 5-6 times a day, alternating with other means of similar action. In the flowers and leaves of this plant there is an essential oil, which includes such valuable substances as geraniol, pinene, cyneol, myrcene, in addition, the plant and its preparations contain tannins, alkaloids, flavonoids, coumarins, saponins, azulene, hyperoside , hyperin, hypericin, resinous substances, ascorbic acid, carotene (provitamin A), vitamins P and PP, nicotinic acid, choline and various minerals, so rich in the chemical composition of Hypericum
strong enough antimicrobial and anti-inflammatory effect of its drugs,
- gargle with a warm extract of the leaves of the plantain leaves; preparation of the infusion: 1 tablespoon of dried raw materials, thoroughly crushed with a pestle in a mortar, pour 1 cup boiling water and infuse, wrapping the dishes well with a towel, about 30 minutes, strain through 1-2 layers of gauze, squeeze out the remaining raw materials through the same gauze. Do gargling several times a day, alternating with other means. It is recommended to use fresh infusion preparation, since some biologically active substances are highly volatile and tend to erode quickly, an effective infusion can also be prepared from fresh plantain leaves (2 tablespoons of crushed raw materials should be filled with 1 cup of boiling water). This tool has a powerful antimicrobial, antiviral and anti-inflammatory effect.
- In case of mononucleosis, children need to gargle with a decoction of globular eucalyptus leaves. Cooking broth: chop the dried leaves into powder, pour 1 cup of this raw material with 1 cup of water and cook at a low boil for 8-10 minutes, then quickly cool the product, strain through 1-2 layers of gauze, squeeze the remaining raw material. Means to use for rinsing without fail in a warm form, alternate with the use of other antiseptic and anti-inflammatory agents, the essential oil in eucalyptus leaves contains a large amount of vitamins. Thanks to these vitamins, the decoction also has a nourishing effect on the mucous membrane.
- gargle with warm infusion of flowers and leaves of a campanula crowded. Preparation of infusion: 1 dessert spoonful of dried herbs, crushed to a powdery state, pour in a thermos, preheated with hot water, pour 1 cup boiling water and leave to cool for a few hours, allow to cool, strain through 1-2 layers of gauze. Gargle several times a day. To restore children after mononucleosis, it is better to use fresh rinsing, alternating with other means. The infusion exhibits an antiseptic and anti-inflammatory effect.
How and how to treat infectious mononucleosis in young children
If the child is sick with mononucleosis, you can use the following recipes of traditional medicine.
- Gargle with a decoction of rhizomes with erect roots. Cooking broth: grind dried rhizome to a state of powder, 1 tablespoon of this raw material pour 250 ml of water and cook on low heat until the volume of broth decreases to 200 ml, then quickly ready to cool, strain through 1-2 layers of gauze , it is good to wring out the remaining raw materials. Perform rinsing several times a day. The broth is used without fail in the form of heat. The underground part of the Potentilla contains essential oil, tannins, glycosides, gum, starch, sugar, quinic and ellagic acids, ascorbic acid, important minerals such as iron, copper, potassium, magnesium, calcium, manganese, barium, zinc, selenium другие вещества, препараты, приготовленные из корневища, обладают противомикробным и противовоспалительным действием, помимо этого, препараты растения сужают просвет кровеносных сосудов и уменьшают проницаемость капилляров,
- полоскать горло водно-спиртовым раствором прополиса — и начать делать это как можно раньше. Preparation of the remedy: first prepare the propolis alcohol solution, grind the propolis with a knife and dissolve in medical alcohol (1: 4 ratio), insist in a few days, shaking occasionally, the water-alcohol solution is prepared immediately before use, for it It is required to add 4-5 drops of propolis alcohol solution to 1/2 cup of warm water and stir, the water will become somewhat cloudy and acquire a slightly yellowish color. This solution should gargle 5-6 times a day. After each rinse, do not eat or drink for 20-30 minutes. For a water-alcohol solution of propolis is characterized by a strong antiseptic and some anti-inflammatory effect. The effectiveness of treatment will be greater if you alternate the use of this solution with the use of other antiseptic and anti-inflammatory rinses,
- gargle regularly with warm infusion of garlic (it is also called garlic water). To prepare this folk remedy for mononucleosis, you need to mash 2 cloves of fresh garlic with a pestle in a mortar to a mushy state and pour 1 cup of boiling water on it, infuse it, tightly covered with a lid (so that the volatility with high volatility does not erode), about 20 minutes, strain through 1- 2 layers of gauze, rinse to do 3-4 times a day. After each rinse, do not eat or drink for half an hour so that the remedy can have a healing effect - antiseptic and anti-inflammatory. Use only fresh preparation,
- a child with severe pain in the throat should chew the fresh leaves of the large plantain, while saliva can be swallowed. Do so 2-3 times a day without fail after meals. The leaves of the plantain contain biologically active substances that cause disinfectant, anti-inflammatory and analgesic effect of the plant and its preparations,
- use the following simple, but very effective folk remedy: take a fresh cucumber, heat it in warm water and slowly rush to chew on the pulp of cucumber in mush. Gruel and juice mixed with saliva can be swallowed. In addition, it is very useful to drink warm cucumber juice in small sips, ascorbic acid contained in juice, like other vitamins with antioxidant properties, has a known antiseptic and anti-inflammatory effect. Drink cucumber juice after meals.
Inhalation to restore children after mononucleosis
With the popular treatment of mononucleosis, inhalation is very effective.
- Regularly inhale with oils of lemon, fir, eucalyptus. Technique of the procedure: put a few drops of oil in a cup (or in a deep plate) of hot water and, leaning over this cup, covered with a towel, breathe evaporation - inhale the vapor in your mouth, and exhale through your nose. Perform the described procedure 1-2 times a day. These oils have a well-pronounced antiseptic effect, nourish the mucous membrane well, settling on the mucous membrane, the oils form the thinnest film that protects the membrane from the irritating effect of some environmental factors,
- do inhalation with the infusion of wild rosemary herb. Preparation of the infusion: Pour 1 tablespoon of dried, chopped raw materials with 1-2 glasses of boiling water and leave in a sealed container at room temperature for half an hour, strain through cheesecloth and boil, the preparation prepared in this way should be poured into a 5-8 l pot, the edges of the pan cover with a napkin or towel, lean over the pan, cover with a blanket or a thick blanket, inhale warm steam with the mouth, and exhale through the nose. Procedure to perform within 15-20 minutes. It is recommended that the child be inhaled several times a day. After each inhalation, be sure to rest in bed for 20-30 minutes,
- perform inhalation with infusion of chamomile flowers. Preparation of infusion: 1 tablespoon of dried flowers, crushed to a state of powder, pour 1.5-2 cups boiling water and leave in a sealed container at room temperature for about 30 minutes, strain through 2 layers of gauze, bring to a boil. Pour into a pan of a suitable container, cover the edges of the pan with a towel or gauze napkins, cover with a thick blanket and inhale warm steam for a quarter of an hour - inhale the steam with your mouth wide open, exhale through your nose. The procedure should be performed 2-3 times a day. Duration of treatment is 6-7 days. The tool has antimicrobial, anti-inflammatory and analgesic effect,
- do inhalation with infusion of herbs Lemon balm. Preparation of infusion: 2 tablespoons of dried raw materials, pounded to a state of powder, pour 1-1.5 cups of boiling water, leave for a quarter of an hour, strain through 1-2 layers of gauze. The remedy prepared in this way must be boiled, poured into a pot with a capacity of up to 8 l, cover the edges of this pan with a towel or napkin, bend over the pan, cover with a blanket or blanket, inhale warm steam through the mouth, and exhale through the nose. The duration of the procedure is 15-20 minutes. Perform this procedure several times a day. After each inhalation, rest in bed for 30 minutes.
- When mononucleosis in young children it is also useful to make inhalations with infusion of peppermint herb. Preparation of the infusion: 1 tablespoon dried, crushed mint leaves to powder state, pour 1.5-2 cups boiling water and leave in a sealed container at room temperature for about half an hour, strain through 1-2 layers of gauze. Bring the infusion to a boil, pour a suitable container into the pan, cover the edges of the pan with a towel or gauze napkin, cover with a thick blanket and inhale warm steam for a quarter of an hour (inhale the steam with the mouth wide open, and exhale through the nose). Procedure to perform 2 times a day. After the procedure, rest in bed for 30 minutes. Duration of a course of treatment - 1-2 weeks. The tool has a well-defined antimicrobial, antiviral and anti-inflammatory effect,
- regularly perform inhalation with infusion of leaves of birch wart. Preparation of infusion: 2-3 tablespoons of dried, powdered young leaves pour 1-1.5 cups of warm boiled water and leave in a sealed container at room temperature for a few hours, strain through 1-2 layers of gauze. Cooked means boil, pour into a saucepan of sufficient capacity, gently overlap the edges of the pan with a towel, bend over the pan, cover with a blanket or blanket and inhale warm steam with your mouth for 15 minutes. The procedure must be performed 2-3 times a day. Rest after the procedure in bed with 30 minutes. Infusion acts as a disinfectant and anti-inflammatory agent.
- do inhalation with decoction of the root of elecampus. Cooking broth: 1-2 tablespoons of dried, well-crushed raw materials pour 2 cups of water and cook on low heat for 15-20 minutes, strain through cheesecloth. Pour into the pot with a capacity of 5-8 liters, cover the edges of the pan with gauze napkins or a towel, lean over the pan, cover with a blanket or a thick blanket, inhale warm steam with the mouth, and exhale through the nose. Procedure to perform within 15-20 minutes. It is recommended to do such inhalations 2-3 times a day. After each procedure, be sure to rest in bed for 30 minutes,
- do inhalation with infusion of herbs oregano ordinary. Preparation of the infusion: Pour 1 teaspoon of dried grass with 1.5-2 cups boiling water and leave in a sealed container at room temperature for several hours, strain through 1-2 layers of gauze, boil, take a pot of sufficient capacity, pour the prepared product into it , cover the edges of the pan with a dry towel, bend over the pan, cover with a blanket or a large towel and inhale warm steam with your mouth for 15-20 minutes. You can perform the procedure several times a day. After the procedure, you should rest in bed for 30 minutes. The tool well inhibits the infection, has a pronounced anti-inflammatory effect,
- do inhalation with infusion grass swamp grass. Preparation of infusion: 1-2 tablespoons of dried, chopped raw materials pour 1 cup boiling water and infuse at room temperature for at least 20 minutes, strain through 1-2 layers of gauze, then the product should be boiled, poured into a saucepan with a capacity of 5— 8 l, edges This pot should be covered with a towel or gauze, bend over the pan, cover with a thick blanket, inhale warm, wet steam through the mouth, exhale through the nose. The duration of the procedure can be up to 20 minutes. Perform this procedure several times a day. After each inhalation rest in bed for 20-30 minutes
- to make inhalations with a decoction prepared on the basis of the following collection of plants: white willow bark - 1 part, wart birch buds - 1 part, common pine buds - 1 part, bird cherry leaves - 1 part, male dogwood root - 1 part, horseradish rhizome - 1 part, rhizomes with calamus roots - 1 part. Cooking broth: 1 tablespoon of this dried, well-crushed raw materials pour 1.5-2 cups boiling water and heated in a boiling water bath for 15-20 minutes, then infuse, tightly wrapped dishes with a towel, at least 45 minutes, strain through gauze . Bring the product to a boil, pour into a saucepan, cover the edges of the saucepan with a dry towel or gauze, lean over the saucepan, cover with a thick blanket or blanket, inhale the wet warm steam with the mouth, exhale through the nose. The procedure should be performed within 15 minutes, such inhalations are recommended to be done 2-3 times a day. After each inhalation, you need to rest in bed for 30 minutes,
- do inhalation with infusion prepared on the basis of a multicomponent mixture of the following composition: wart birch buds - 1 part, black chokeberry fruit - 1 part, chamomile flowers - 1 part, horsetail grass - 1 part, rosehip cinnamon - 1 part, pepper fruits sweet - 1 part. Preparation of the infusion: 5-10 g of this dried mixture, crushed to a state of powder, put into a pre-heated thermos, pour 1-1.5 cups of boiling water and infuse for several hours, strain through 2 layers of gauze. Boil the product, pour sufficient container into the pan, cover the edges of the pan with a towel or gauze, lean over the pan, cover with a blanket or a thick blanket, inhale the warm steam with the mouth wide open, exhale through the nose, this procedure is carried out for a quarter of an hour; once a day. After each inhalation, be sure to rest in bed for 20-30 minutes. Full course of treatment - up to 2 weeks,
- during the recovery period, when the tonsils are gone, it is recommended to gently lubricate the surface of the tonsils with calendula, chamomile, peppermint, lemon, fir, eucalyptus oils, the procedure is performed with a small cotton or gauze pad, there is a little oil (because it is expensive), and it has to be used more economically - put a few drops of oil on the tongue to the sick child and ask to be swallowed. When the child makes a swallowing movement, the oil spreads over the back of the tongue and soon ends up on the surface of the tonsils. After each lubrication, the child does not eat or drink for 20-30 minutes so that the oil has time to show its therapeutic and nourishing effect,
- A child suffering from an infectious mononucleosis (especially when the pharyngeal tonsil is affected) can bury the oils mentioned above and into the nose. During the procedure, the child should lie on his back, tilting his head slightly or slightly hanging it from the couch. After the procedure, you should lie in this position for about 1 minute, during which time the oil will have time to reach the arch of the nasopharynx and will spread over the surface of the pharyngeal tonsil. After the child rises, the oil will flow down the walls of the nasopharynx into the oropharynx, lubricate the mucous and there, enough for one instillation 5-6 drops of oil. It is recommended to perform the described procedure several times a day. If a child has a lot of mucus from the nose, before the procedure it is necessary to rinse the nose and nasopharynx with warm boiled water or infusions, decoctions of medicinal plants with antiseptic and anti-inflammatory effects.
How to cure a child who is sick with mononucleosis
For the treatment of mononucleosis folk remedies it is recommended to use infusions and decoctions for washing the nose and nasopharynx.
- For inflammation of the pharyngeal tonsil, use infusions and decoctions of various medicinal plants for washing the nasal and nasopharyngeal cavities. You can, for example, start washing with a warm broth of chamomile flowers. Cooking broth: Dried flowers thoroughly crushed with a pestle in a mortar, 1 tablespoon of this raw material pour 1 glass of water and cook at a low boil for 7-10 minutes, then allow to cool, strain through 1-2 layers of gauze, squeeze out the remaining raw materials. A decoction of chamomile flowers is distinguished by a well-marked antiseptic, anti-inflammatory, and some analgesic effect. It is recommended to alternate the use of this folk remedy for infectious mononucleosis using other means of similar action,
- For regular washing of the nasal and nasal cavities of the child, you can also use a warm decoction of the herb sage. Cooking broth: dried grass is well crushed with a pestle in a mortar, 5-6 g of powder pour 1 cup of boiling water and heated in a boiling water bath for 12-15 minutes, then quickly cool the product, strain through 1-2 layers of gauze. The product is characterized by a well-pronounced disinfectant and anti-inflammatory effect.
- To cure mononucleosis in a child, it is recommended to wash the nasal and nasopharyngeal cavities with warm infusions of the flowers and leaves of Hypericum perforatum, calendula medicinal flowers, creeping thyme herb, peppermint herb, and warm broth of spherical eucalyptus leaves. With each washing performed correctly, the infection is removed from the mucosal surface with a stream of fluid. These drugs, in addition, affect the flora depressing, anti-inflammatory and often - an analgesic effect,
- wash the nasal and nasopharyngeal cavities with a warm extract of cinnamon rosehip. Preparing the infusion: Pound the dried fruits with a pestle in a mortar, pour 1 cup of raw materials with 1 cup of cold boiled water and leave for 6-8 hours in a sealed container, strain through 2 layers of gauze, squeeze the rest of raw materials. Ascorbic acid, which is contained in large quantities in this agent, has a known antimicrobial, antiviral and anti-inflammatory effect.
Opinion of Dr. Komarovsky
The well-known pediatrician Yevgeny Komarovsky, whom young parents know from TV shows and consultations on the Internet, warns: antibiotics do not cure infectious mononucleosis because the disease is viral in nature.
Moreover, if a child is given similar pills (for example, ampicillin), rashes will appear on his body, and new alarms may appear on his parents: maybe it is an allergy, exanthema (skin rash, which appears on the skin in various viral diseases) or atopic dermatitis?
Komarovsky's recommendations to treat mononucleosis in children (in adolescents and children up to one year old) are symptomatic: if the temperature is high - to give antipyretic, for pain in the throat - rinsing (this applies to older children who can cope with this task).
And one more tip from the pediatrician: to help the child recover from the disease, it is necessary to more reliably protect him from other misfortunes, for this purpose - to walk more on the street and to have less contact with other children.
According to Komarovsky, immunostimulants are ineffective in this situation.
In the following video, Dr. Komarovsky will talk about mononucleosis:
Recovery and rehabilitation after illness
Restoration of the body after suffering mononucleosis is not fast.
Whoever is sick, child or adult, within a year after recovery, he is faster than usual, gets tired, feels weak, sleep is often disturbed, insomnia worries.
Guys usually care about when they can start playing sports, and young people - when they can kiss without the risk of infecting a partner.
Doctors do not advise to rush things, because physical exertion is contraindicated at first.
In order for rehabilitation of the mononucleosis to be successful, it is necessary, for at least six months, to refuse to visit sports sections, hiking trips and long-distance trips.
You can not overheat or overcool the body, but unhurried walks in the fresh air that strengthen the immune system are extremely useful.
Нужно придерживаться диеты, наблюдаться в диспансере и, при подозрениях на какие-либо осложнения, консультироваться у врача-гепатолога, невропатолога или какого-то иного специалиста для решения текущих проблем.
Можно ли купаться в море и загорать на солнце
Несколько лет назад и взрослым, и детям после мононуклеоза категорически не разрешали ни купаться в море, ни принимать солнечные ванны.
The argument is the negative effect of ultraviolet on the body’s immune barrier: it should be restored after an illness, and the sun supposedly impedes this process.
Considering the herpes nature of mononucleosis and the fact that its “closest relative”, herpes type 6 under the influence of hot rays can provoke a relapse of the disease, the doctors in the case of mononucleosis decided to play it safe.
Today, however, these arguments, without receiving scientific evidence, are questioned.
Yevgeny Komarovsky, for example, asserts: you can safely go to the sea, get a tan, bathe under one condition - respect for the sense of proportion.
By the way, moderate sun exposure protects the body from the development of multiple sclerosis, which often develops in those who have been ill with mononucleosis.
When to get vaccinated
The disease is a disease, and vaccines - vaccinations. We can not allow the body of the child was, having been ill with mononucleosis, defenseless against other infections.
The Internet, in search of an answer to the question of when it is possible to inoculate a baby (for example, manta), refers to an official document - guidelines 220.127.116.115-02 on the order of preventive vaccinations.
If the disease is severe, it will take 2-4 weeks. In practice, pediatricians, as a rule, extend the terms to 6-12 months. It all depends on the individual characteristics of the organism, its readiness for one or another test.
Unfortunately, there are no preventive measures by which an infection could not approach a person.
However, it is known that strong immunity is a good defense, including against infectious mononucleosis. How to create this protection?
- to live an active lifestyle,
- eat full, balanced,
- Do not overload the body with overwork - physical and mental,
- adhere to a reasonable daily routine, which takes into account and complete sleep, and rest.
Indications and contraindications to use, as well as detailed instructions on the use of cream and emulsion Emolium presented in this material.
If you are interested in how herpes is transmitted to the lips, read our publication.
What causes infectious mononucleosis?
Epstein-Barr virus type 4 belongs to the family of herpes viruses and is the causative agent of infectious mononucleosis.
This virus contains genetic material that is represented by double-stranded DNA. Virus multiplication occurs in human B lymphocytes.
Pathogen antigens are represented by capsid, nuclear, early, and membrane types. In the early stages of the disease, capsid antigens can be detected in the child’s blood, since other antigens appear during the height of the infectious process.
The Epstein-Barr virus is adversely affected by direct sunlight, heating and disinfecting agents.
How is mononucleosis transmitted?
The source of infection in mononucleosis is a patient with a typical or atypical form, as well as an asymptomatic carrier of the Epstein-Barr type 4 virus.
For infectious mononucleosis, the characteristic airborne pathway, that is, it expands its presence when sneezing, coughing, kissing.
Also, the virus can be transmitted through household and hematogenous routes.
More often, children who live in dormitories, boarding schools, orphanages, as well as those who go to kindergarten are ill.
What is the mechanism of development of infectious mononucleosis?
The infection enters the human body through the mucous membrane of the upper respiratory tract (mouth, nose and throat), which leads to swelling of the tonsils and local lymph nodes. After that, the pathogen spreads throughout the body.
Infectious mononucleosis can be cured, but even after recovery, the virus remains in the child’s body and can, under adverse conditions, begin to multiply again, which is fraught with a relapse of the disease.
What forms of mononucleosis in children?
Infectious mononucleosis can be acute and chronic. It is also customary to single out typical and atypical forms of the disease. Typical mononucleosis, in turn, is divided by severity: mild, moderate and severe.
Atypical mononucleosis can occur with worn out symptoms, asymptomatic or only with signs of damage to internal organs.
If the disease is classified according to the presence of complications, infectious mononucleosis can be uncomplicated and complicated.
In children, the symptoms of acute mononucleosis appear sharply. The incubation period of the disease ends with a rise in body temperature to high numbers (38-39 ° C).
When mononucleosis in children are present following symptoms:
- lymphadenopathy, first of all, cervical and in-the-ear lymph nodes,
- pain in the area of enlarged lymph nodes
- swelling of the throat mucosa, which is manifested by difficulty breathing,
- hyperemia of the throat,
- sore throat,
- nasal congestion,
- general weakness
- pains in muscles and joints,
- a white coating on the mucous membranes of the tongue, the sky, the tonsils and the back of the throat,
- splenomegaly (enlargement of the spleen),
- hepatomegaly (enlarged liver),
- small, red and thick rash on the face, neck, chest or back,
- eyelid edema
- photophobia and others.
To determine reliably the cause of mononucleosis chronization experts have not yet succeeded.
But there are a number of factors which contribute to this:
- unhealthy food
- bad habits,
- sedentary lifestyle,
- frequent psycho-emotional turmoil,
- hormonal changes during puberty,
- mental and physical fatigue and others.
Chronic mononucleosis in children is characterized by symptoms of the acute course of the disease, only their severity is less intense.
In children, there is a worsening of the general condition, which is expressed by general weakness, drowsiness, fatigue, decreased activity, etc. Also, a violation of the stool may appear in the form of constipation or diarrhea, nausea, rarely - vomiting.
What is dangerous mononucleosis?
In general, the course of infectious mononucleosis is mild and uncomplicated. But in rare cases can occur the following complications:
- bronchial obstruction,
- inflammation of the meninges and brain tissue,
- the accession of bacterial flora (bacterial sore throat, pneumonia and others),
- immunodeficiency and others.
But the most dangerous complication of infectious mononucleosis is the rupture of the capsule of the spleen, which is characterized by following symptoms:
- loss of consciousness,
- severe weakness
- severe abdominal pain.
How is the diagnosis of infectious mononucleosis in children?
Algorithm for the diagnosis of infectious mononucleosis in children consists of several steps.
Subjective diagnostic methods:
- patient survey
- collection history of disease and life.
Objective methods of research of the patient:
- examination of the patient
- palpation of the lymph nodes and abdomen,
- percussion abdomen.
Additional diagnostic methods:
- laboratory diagnostics (complete blood count, biochemical blood test, blood test to determine antibodies to Epstein-Barr virus),
- instrumental diagnostics (ultrasound examination of the abdominal cavity organs, including the liver and spleen).
When interviewing the patient pay attention to the symptoms of intoxication, pain in the throat and jaw, and also clarify whether there was no contact with children with infectious mononucleosis.
When examining patients with mononucleosis, an increase in the bony lymph nodes is often observed, and in small children an enlarged liver or even the spleen is clearly visible. When inspecting the throat is determined by its grain, redness and swollen mucous.
On palpation, enlarged and painful lymph nodes, liver and spleen are determined.
In the patient's blood, it is possible to detect such indicators as insignificant leukocytosis, an increase in the erythrocyte sedimentation rate, and the presence of wide plasma lymphocytes.
A specific sign of infectious mononucleosis is the appearance in the blood of atypical mononuclear cells - giant cells with a large nucleus, which consists of many nucleoli. Atypical mononuclear cells can stay in the blood of a recovered child up to four months, and sometimes even longer.
But the most informative blood test for mononucleosis is the detection of antibodies to the pathogen or the determination of the genetic material of the virus itself. To do this, conduct enzyme immunoassay (ELISA) and polymerase chain reaction (PCR).
What is the need for conducting and decoding of ELISA and PCR? Decoding the listed blood tests is necessary to identify the virus and confirm the diagnosis.
If the diagnosis is unclear, the attending doctor considers the need for an HIV test, since this disease can cause the growth of atypical mononuclear cells in the blood.
Ultrasound examination of the abdominal organs allows to determine the degree of hepato-and splenomegaly.
How to treat infectious mononucleosis? What does Dr. Komarovsky recommend?
Infectious mononucleosis in children Komarovsky in his book devoted an article where he describes in detail the symptoms and treatment of this disease.
The well-known TV specialist, like most experts, argues that the specific treatment of mononucleosis has not yet been developed and, in principle, it is not necessary, because the body is able to cope with the infection on its own. In this case, adequate prevention of complications, symptomatic treatment, stress reduction and nutrition play a major role.
It is possible to treat infectious mononucleosis in children at home under the guidance of a pediatrician and an infectious disease specialist. In severe cases, the patient is hospitalized in the infectious disease ward or hospital.
Indications for inpatient treatment is an:
- temperature above 39.5 ° C
- marked swelling of the upper respiratory tract,
- severe intoxication
- appearance of complications.
In the treatment of infectious mononucleosis, Komarovsky recommends adhering to following principles:
- bed rest
- antipyretic therapy at body temperature above 38.5 degrees, as well as if the child does not tolerate fever. In such cases, appoint Nurofen, Efferalgan, Ibuprofen and others,
- in case of severe inflammation in the throat, local antiseptics are used - Septefril, Lysobact, Orosept, Lugol, as well as local immunotherapy drugs such as Immudon, IRS-19 and others,
- vitamin therapy with complex vitamin preparations, which necessarily contain vitamins of group B, as well as ascorbic acid,
- in violation of the liver apply cholagogue and hepatoprotectors,
- immunotherapy, which is the appointment of interferons or their inducers, namely: Viferon, Tsikloferon, Imudon, human interferon, Anferon and others,
- Antiviral therapy: acyclovir, Vidabarin, Foscarnet and others. For mononucleosis, acyclovir is prescribed at a dose of 5 mg / kg of weight every 8 hours, Vidabarin - at 8-15 mg / kg / day, Foscarnet - 60 mg / kg every 8 hours,
- antibiotics for mononucleosis can only be assigned to a child when attaching secondary bacterial flora (streptococcal sore throat, pneumonia, meningitis, etc.). It is prohibited to use penicillin antibiotics for mononucleosis, as they cause allergies in many children. Also, probiotics such as Linex, Bifi-forms, Acipol, Bifidumbacterin and others are necessarily assigned to the child,
- hormone therapy is indicated for children with severe intoxication. Prednisolone is used for this.
The period of reconvalescence in infectious mononucleosis takes from two weeks to several months, its duration depends on the severity of the disease and on whether there were consequences.
The patient's condition improves literally one week after the normalization of body temperature.
During the period of reconvalescence, a full and balanced diet is recommended, which we will describe in more detail later.
If the temperature is maintained during mononucleosis, this may indicate the accession of the secondary bacterial flora, since during the recovery period it should not exceed 37.0 ° C.
It is possible to visit the kindergarten after mononucleosis when the indices are normalized in the blood, that is, atypical mononuclears disappear.
What you need to follow a diet after mononucleosis in children?
Both during the treatment of infectious mononucleosis and after recovery, patients should follow a diet, especially if the liver was affected.
Food should be balanced and easily digested so as not to overload the liver. In case of hepatomegaly, Pevsner table No. 5 is prescribed, which implies restriction of animal fats, excluding spicy seasonings, spices, marinades, sweets and chocolate.
The patient's menu should consist of liquid soups, semi-liquid porridges, lean meats, poultry and fish. When cooking, it is recommended to use gentle methods of heat treatment, such as boiling, baking or steaming.
Diet after infectious mononucleosis should be followed from 3 to 6 months, depending on the severity of the disease. After this period, the menu can be expanded and diversified.
Medicinal herbs such as chamomile, milk thistle, corn stigmas, lemongrass and others that are used in the form of tea help restore the cells of the liver.
It is also important in case of infectious mononucleosis to observe an adequate drinking regimen according to age.
What are the methods of prevention of infectious mononucleosis in children?
Specific prevention of infectious mononucleosis has not been developed. To prevent the development of the disease by strengthening the immune system using the following methods:
- active and healthy lifestyle
- child compliance with the rational mode of the day,
- exclusion of mental and physical overload
- dosed sports loads
- sufficient time to stay in the fresh air
- healthy and balanced diet.
Therefore, at the first signs of infectious mononucleosis in your child, we strongly recommend that you contact a pediatrician at the nearest clinic or immediately to an infectious diseases specialist and in no case be self-medicated.