What kind of disease is this? A mononucleosis is an infectious viral disease that occurs with damage to the tonsils, liver, several groups of lymph nodes and the spleen; undergoes specific changes and cellular composition of blood.
The clinical picture often resembles a sore throat so much that one cannot do without specific analyzes.
By affecting mostly children, the virus can remain in the body until the end of a person’s life. The connection of this infection with slow infections and neoplastic processes (Burkitt’s lymphoma, nasopharyngeal carcinoma) was also revealed.
Causes of Infectious Mononucleosis
What kind of disease is mononucleosis, and why does it occur? Epstein-Barr virus, which belongs to the group of herpes viruses, has antigens common with the herpes simplex virus. Shows a special affinity for one of two types of human lymphocytes (immune cells), which can remain throughout life.
The only source of infection is a person who can be both sick and a carrier of the virus. This virus is excreted with the saliva of an already recovered person for another 12-18 months. At the same time, the isolation of viruses may occur more actively if a person carrying another viral or bacterial disease, which is accompanied by suppression of immunity, as well as during chemotherapy or radiotherapy.
In order for the disease to develop, the virus must go to the mucous membrane of the nasopharynx or directly into the blood of a healthy person.
Possible ways of transmission of the virus in children and adults:
- 1) Drip: when talking at a distance, the transmission of the virus is not as likely as when kissing, sneezing, coughing;
- 2) Through household items, toothbrushes, dishes, toys;
- 3) In case of transfusion of infected blood, transplantation of organs from a virus carrier;
- 4) Through the placenta;
- 5) The sexual way is possible, but not proven.
The incidence of morbidity falls on 2-10 and 20-30 years. Pathology develops in the form of family outbreaks, less often – small outbreaks in closed collectives.
Symptoms of Infectious Mononucleosis
In adults and children, the incubation period for mononucleosis is very long – 20-60 days.
During this time, the virus from the nasopharynx, gastrointestinal tract, genital tract enters the bloodstream and is introduced into the lymphocytes, which become involuntary lifelong carriers of the virus.
Further prodromal symptoms of infectious mononucleosis develop:
- muscle and headache;
- loss of appetite.
After a few days – 2 weeks, three main symptoms develop that are considered classic for infectious mononucleosis:
- 1) Temperature increase: often (in 85-90% of cases) – to high numbers, less often the temperature remains up to 38 ° C. Fever with this disease is not accompanied by severe chills or sweat. There is hyperthermia from several days to months, does not affect the severity of other symptoms.
- 2) Swollen lymph nodes. The lymph nodes of the cervical group are usually the first to suffer, then the axillary or inguinal ones increase (depending on the way the virus has penetrated). In the process are involved and the nodes that collect lymph coming from the internal organs – located in the mesentery of the intestine and near the bronchi.
- from pea to walnut;
- moderately painful;
- freely shifted relative to the underlying tissues;
- the skin above them has the usual temperature and color;
- when the nodes of the peritoneum are inflamed, a person will feel pain in the abdomen (usually lower right), with involvement of the peri-bronchial lymph nodes – cough, difficulty breathing.
Sore throat due to inflammatory changes in it:
- tonsils are enlarged;
- whitish or dirty gray on the tonsils, which is easily removed;
- rear wall of the pharynx reddened, edematous.
In addition to the above triad of symptoms of mononucleosis, there are:
- 1) Enlarged liver and spleen – maximum by 5-10 days of illness. May be accompanied by a slight yellowness of the sclera, sometimes – and skin. This symptom is dangerous in terms of possible rupture of these organs (especially the spleen) at the slightest injury, which causes the appointment of a strict bed rest for this patient. The liver and spleen begin to decrease from 3-4 days after the temperature returned to normal.
- 2) A rash on the skin in the form of spots, small hemorrhages, may be similar to a rash with scarlet fever. Elements of rash may also appear on the soft palate. This symptom can develop and disappear in any period of the disease.
- 3) In the general analysis of the blood, cells are identified – atypical mononuclear cells, of which more than 10%.
The disease usually lasts at least 2 weeks. At 3-4 weeks, complications of this disease may develop, and recovery may begin. In rare cases, the process is delayed for 2-3 months or more.
Diagnosis of infectious mononucleosis
Mononucleosis can be suspected not only by the clinical picture, but after obtaining the results of a general blood test, in which more than 10% of atypical mononuclear cells are determined.
To confirm the diagnosis using these methods:
- 1) Serological testing of blood for antibodies to Epstein-Barr virus: mononucleosis has an increased titer of immunoglobulins of class M to it, whereas detection of only anti-EBV IgG is an indicator of the disease, and not an acute process;
- 2) In the conditions of the serological laboratory, the determination of blood antigens (membrane and capsid) of Epstein-Barr virus is carried out;
- 3) PCR examinations of blood and buccal (on the part of the mucous membrane of the cheeks) scraping. If it is mononucleosis, then virus DNA will be detected in the scraping and in the blood.
Ultrasound examination of the abdominal cavity, chest X-ray, biochemical blood tests are performed to clarify the severity of the disease.
Mononucleosis vaccines are still under development. It is planned to apply them in those regions where malignant forms of the disease are often detected, as well as in youth groups (students, military personnel).
As a nonspecific prevention, it is important to observe the rules of personal hygiene, the acquisition of the habit of not communicating without a mask with a febrile patient. Also, prevention is a thorough examination of donors for the carrier of the virus.
Since the virus is not highly contagious, there is no special isolation, disinfecting treatment, and prescription of prophylactic drugs for contact persons.
Complications of Infectious Mononucleosis
Which doctor to contact for treatment?
If, after reading the article, you assume that you have symptoms characteristic of this disease, then you should consult a general practitioner.