Mononucleosis- acute infection, characterized by damage to the reticuloendothelial and lymphatic systems and proceeding with fever, tonsillitis, polyadenitis, enlargement of the liver and spleen, leukocytosis with a predominance of basophilic mononuclear cells.
Infectious mononucleosis is caused Epstein-Barr virus(DNA-containing virus of the genus Lymphocryptovirus). The virus belongs to the herpesvirus family, but unlike them, it does not cause the death of the host cell (the virus mainly multiplies in B-lymphocytes), but stimulates its growth.
The reservoir and source of infection is a sick person or a carrier of an infection. An infectious disease doctor treats mononucleosis. Epstein-Barr viruses in a latent form are stored in B-lymphocytes and in the epithelium of the mucous membrane of the oropharynx.
What is mononucleosis
Infectious mononucleosis is found everywhere and affects people of all age groups. In developed countries, the disease is recorded mainly among adolescents and young people, peak incidence falls on 14-16 years for girls and 16-18 years for boys. In developing countries, children of younger age groups are more likely to get sick.
Rarely, infectious mononucleosis occurs in adults over 40 years of age, because. most people at this age are immune to this infection. In children under 2 years of age, the disease, as a rule, is not diagnosed due to the latent course. Infectious mononucleosis slightly contagious: mostly sporadic cases, occasionally small epidemic outbreaks.
Symptoms of mononucleosis
Disease develops gradually with fever and severe sore throat: there is a sore throat. Patients complain of well-being, loss of strength and loss of appetite. Typically, smokers lose their desire to smoke.
Cervical, axillary and inguinal lymph nodes gradually increase, swelling becomes visible. Inflammation of the cervical lymph nodes(cervical lymphadenitis), as well as tonsillitis, are typical signs of infectious mononucleosis.
Enlarged lymph nodes are elastic and painful on palpation. Sometimes body temperature reaches 39.4–40°. The temperature is kept at a constant level or fluctuates during the day, decreasing at times (in the morning) to normal. When the temperature rises, headaches are noted, sometimes severe.
From the first days of illness sizes increase liver and spleen, reaching a maximum by 4-10 days. Sometimes there are dyspepsia, abdominal pain. In 5-10% of patients, mild icterus of the skin and sclera occurs.
Other symptoms also appear:
- jaundice;
- skin rash;
- stomach ache;
- pneumonia;
- myocarditis;
- neurological disorders.
In some cases, an increase in the activity of transaminases in the blood is detected, which indicates a violation of liver function. At the height of the disease or at the beginning of the convalescence period, patients receiving antibiotics develop an allergic rash (maculopapular, urticarial, or hemorrhagic). More often this happens when penicillin drugs, as a rule, ampicillin and oxacillin (antibodies to them are found in the blood of patients).
The disease continues 2-4 weeks, sometimes longer. At first, fever and raids on the tonsils gradually disappear, later the hemogram, the size of the lymph nodes, spleen and liver are normalized.
In some patients, a few days after the decrease in body temperature, it rising again. Hemogram changes persist for weeks and even months.
Symptoms of mononucleosis in children
Children complain of the following symptoms:
- lack of appetite;
- nausea;
- headache;
- chills;
- pain in the sacral region, in the joints.
Then there is laryngitis, dry cough, sore throat, fever. During this early period, the disease is diagnosed as influenza. In some children, these symptoms disappear after a few days. Careful clinical observation states an increase and soreness of the cervical lymph nodes. Other children develop the classic picture of the disease after this period.
Important: sometimes the course of mononucleosis becomes acute. The child develops chills, fever reaches 39°-40°. The elevated temperature lasts for 7-10 days, and sometimes longer. Often this is accompanied by symptoms from the nasopharynx.
The latter in some children proceed without features (catarrh of the nose or throat), in others - tonsillitis, which sometimes takes on an ulcerative and even diphtheria character. The changes that have occurred in the throat and tonsils become the gateway for a secondary infection, sometimes proceeding septically.
A typical symptom of mononucleosis is rash on the palate. In addition, in addition to the symptoms of angina, some children develop swelling of the soft palate, tongue and larynx, as well as swelling of the oral mucosa. Gums soften, bleed, ulcerate.
Sometimes there is inflammation of the cornea of the eyes and the mucous membrane of the eyelids. The temperature is holding 10-17 days, in some cases up to a month. Sometimes subfebrile temperature lasts for months.
A characteristic feature of this syndrome is an increase in lymph nodes, mainly cervical and nodes located behind the sternocleidomastoid and submandibular muscles (75% of cases), less often inguinal and axillary (30% of cases), sometimes occipital and elbow. Mesenteric and mediastinal nodes may also increase.
Nodes increase either singly or in groups. As a rule, the nodes are small, elastic, painful when pressed, which often occurs in the cervical nodes, and then only if there are large changes in the tonsils. Rarely there is a symmetrical enlargement of the nodes. Abdominal pain, nausea, vomiting and diarrhea are associated with an increase in mesenteric nodes.
Descriptions of symptoms of mononucleosis
Diagnosis of mononucleosis
Infectious mononucleosis is diagnosed based on several tests:
Also, a prerequisite for the development of mononucleosis is considered the presence of mononuclear cells. These cells are found in the blood in mononucleosis and their number is increased by 10% of the norm. At the same time, mononuclear cells are not detected immediately after the onset of the disease - as a rule, 2 weeks after infection.
When a single blood test fails to identify the cause of the symptoms, the presence of antibodies to the Epstein-Barr virus is determined. Frequently ordered research PCR, which helps to get the result quickly. Sometimes a diagnosis is made to determine HIV infection, which manifests itself as mononucleosis.
To determine the causes of the resulting sore throat and differentiate from other diseases, an otolaryngologist is appointed to consult, who does a pharyngoscopy to help determine the cause of the disease.
Treatment of mononucleosis
sick light and medium forms of infectious mononucleosis are treated at home. The need for bed rest is determined by the severity of intoxication.
Which doctors to contact for mononucleosis
Treatment of mononucleosis is symptomatic. Antiviral, antipyretic, anti-inflammatory drugs and immune boosters. Application Shown local antiseptics for disinfection of the mucous membrane of the throat.
It is allowed to use an anesthetic spray, solutions for rinsing the pharynx. If there is no allergy to bee products, honey is used. This remedy strengthens the immune system, softens the throat and fights bacteria.
Infectious mononucleosis is often complicated by viral infections - in this case, antibiotic therapy. Patients need to be provided with plentiful fortified drink, dry and clean clothes, and attentive care. Due to liver damage often not recommended take antipyretics, such as paracetamol.
With severe hypertrophy of the tonsils and the threat of asphyxia, prednisone is prescribed for a short course. During treatment worth giving up from fatty, fried foods, hot sauces and seasonings, carbonated drinks, too hot food.
Medications
Important: means of the penicillin group are contraindicated.
As a rule, the following drugs are prescribed for mononucleosis:
- antipyretics (Ibuprofen, Paracetamol);
- vitamin complexes;
- local antiseptics;
- immunomodulators;
- hepatoprotectors;
- choleretic;
- antiviral;
- antibiotics;
- probiotics.
Treatment of mononucleosis in children
Children with mild forms of mononucleosis are treated at home, and in severe forms, when the liver and spleen are enlarged, they are hospitalized in an infectious diseases hospital.
In the acute period of the disease, in order to avoid injury to the enlarged spleen (or its ruptures), it is important to observe bed rest. Treatment of mononucleosis in children is combined with herbal medicine. In this case, decoctions are effective.
They take in equal parts the flowers of chamomile, calendula and immortelle, the leaves of the mother and stepmother, yarrow grass and succession. Grind herbs in a meat grinder. Next, take two tablespoons of the mixture and pour a liter of boiling water. The decoction is infused in a thermos overnight. Take the infusion half an hour before meals, 100 ml.
Children are prescribed a special diet that needs to be followed six months to a year. At this time, nothing fatty, smoked, sweet is allowed. The patient should use as often as possible:
- dairy products;
- fish;
- lean meat;
- soups (preferably vegetable);
- puree;
- cereals;
- fresh vegetables;
- fruits.
At the same time, you will have to reduce the consumption of butter and vegetable oil, sour cream, cheese, and sausages.
- peas;
- beans;
- ice cream;
- garlic.
After recovery, for 6 months, the child is observed by an infectious disease specialist so as not to miss complications from the blood. The transferred disease leaves behind stable immunity.
Instructions for use of drugs for mononucleosis
Recovery from mononucleosis
Recovery from infectious mononucleosis occurs under medical supervision. Consultations with a hepatologist are necessary, as well as regular biochemical, serological and blood tests.
When children have a fever, they eat reluctantly, mostly they drink a lot - let it be sweet tea with lemon, non-acidic fruit drinks and compotes, natural juices without preservatives. When the temperature returns to normal, the child's appetite improves. Six months is required to follow the right diet so as not to overload the liver.
Child after mononucleosis, gets tired quickly, feels overwhelmed and weak, needs more time to sleep. You can not overload the child with home and school chores.
To prevent complications mononucleosis, children are required to follow some recommendations for six months:
The child needs leisurely walks in the fresh air, a stay in the village or in the country has a positive effect on recovery after illness.
Complications of mononucleosis
Typically, mononucleosis ends full recovery.
But sometimes there are serious complications:
- febrile syndrome;
- pneumonia;
- uveitis.
Neurological complications
- polyneuropathy;
- encephalitis;
- meningitis;
- mental disorders.
Hematological complications
- decrease in the number of platelets;
- death of red blood cells;
- a decrease in the number of white blood cells.
Spleen rupture
A serious complication of mononucleosis, accompanied by a decrease in blood pressure, severe abdominal pain and fainting.
Causes of mononucleosis
Sources of the causative agent of infection are a person with infectious mononucleosis and a virus carrier. Infection occurs by airborne droplets, by direct contact (for example, by kissing), through household items contaminated with saliva.
In saliva, the virus is found at the end incubation period illness, during the peak and sometimes 6 months after recovery. Isolation of the virus is observed in 10-20% of persons who have had infectious mononucleosis in the past.
How can you get mononucleosis
The source of infection is a sick person or a healthy virus carrier. The disease is not contagious, which means that not everyone who comes into contact with the sick person or the virus carrier becomes ill. You can get infected by kissing, using personal hygiene products together with the patient (towels, washcloths, children when exchanging toys), and by blood transfusion.
Even after the illness, the patient continues to release the Epstein-Barr virus into the environment for a long time (up to 18 months!). This has been proven by numerous studies.
Half of the people suffer from infectious mononucleosis during adolescence: boys at 16-18 years old, girls at 14-16 years old, and the incidence rate drops further.
Persons older than 40 years of infectious mononucleosis are extremely rare. This does not apply to patients with AIDS or HIV-infected, they suffer from mononucleosis at any age, in severe forms and with severe symptoms.
How not to get mononucleosis
There is no vaccination against infectious mononucleosis. There are no special preventive measures aimed at preventing this particular disease either. Doctors' recommendations come down to the fact that it is necessary to increase immunity and perform the same preventive measures as for other viral infections.
To increase immunity, regularly do a set of hardening measures. Wash your face with cool water, walk around the house barefoot, take a contrast shower, gradually increasing the duration of the cold part of the procedure and lowering the temperature of the water. If doctors do not forbid, douse yourself with cold water in winter.
Try to lead healthy lifestyle life, give up bad habits. Include easily digestible foods with vitamins and microelements in your diet: citrus fruits, dairy and other products. Requires physical education, walks in the fresh air, exercises in the morning.
In consultation with the doctor, take drugs that increase immunity. Better of plant origin, for example, tincture of Eleutherococcus, ginseng, Schisandra chinensis.
Since mononucleosis is transmitted by airborne droplets, it is required to exclude contact with a sick person. People who have been in contact with him fall ill within twenty days, counting from the day of the last contact.
If a child who attends is ill kindergarten, it is required to carry out a thorough wet cleaning of the group room, using disinfectants. Shared items (dishes, toys) are also subject to disinfection.
to other children, attending the same group, as prescribed by the pediatrician, a specific immunoglobulin is administered to prevent the disease.
Questions and answers on the topic "Mononucleosis"
Hello, a child for a year and a half has elevated monocytes and atypical mononuclear cells in the blood. Enlarged tonsils and lymph nodes. There is no rash. The liver and spleen are not enlarged. Could this be infectious mononucleosis? Thank you.
The child had been ill with mononucleosis a month ago, the lymph nodes are still enlarged. The temperature is 37, then 36.8
Daughter 11 years old. I got sick with mononucleosis a month ago, and the cervical lymph node passes very slowly, I don’t know how to deal with it. Help me please!
My son is 5 years old. We get sick very often, sometimes more than once a month. A month ago, we were discharged from the hospital after suffering from infectious mononucleosis. Today the temperature has again risen to 37.3 and the throat is reddened. Throughout the month, they took Cecloferon and Viferon. What to do for treatment now? Please tell me.
Lymph nodes sometimes remain enlarged (not inflamed) for quite a long time. If the child feels normal, everything is fine. They will pass with time. Continue to monitor the temperature and show the child to the doctor if the temperature rises above 38.5 C.
Tell me, what tests are needed to detect mononucleosis?
Blood analysis.
I am 29. Three weeks ago, the lymph node on the neck on the right side enlarged and fell ill, the next day the same with the left and the throat was very swollen. After 4 days, the throat passed, a strong cough began and the temperature rose to subfebrile. After another 3 days, the temperature rose to 38, ceftriaxone was prescribed, the temperature rose every day, on the sixth day of the antibiotic it began to drop to normal values, the lymph nodes returned to normal. After 4 days, subfebrile temperature again, after another 2 days, severe swelling of the throat and swollen lymph nodes throughout the body. At the same time, severe sweating at night for two weeks and a dry cough. Could it be mononucleosis?
The diagnosis of mononucleosis is based on laboratory tests.
I am 62 years old. At the end of July, I got a sore throat - I can’t cure it until now. I visited an ENT doctor. I passed the tests - the BARRA virus - 650. The doctor said that she had once had mononucleosis and very low immunity. Having found your site, I read that it is impossible to re-infect with mononucleosis, so why can't I cure my throat. And which doctor should I contact (at the moment I am rinsing alternately with chamomile, diluted alcohol infusion of propolis, tanzelgon and lugol) or is it all about immunity? And what would YOU recommend?
If the ENT did not prescribe treatment and paid attention to immunity, you need to contact an immunologist.
Whether there can be complications on joints after the mononucleosis transferred one month ago?
Unlikely.
On the seventh day, the child (daughter is almost 9 years old) has a temperature, the first 4 days it rose to 39.5. For the first 2 days, the child complained that it hurt to look and had a headache, usually with the flu, nothing else bothered him, they started taking Ingoverin. The throat turned red on the 4th day, but there was no plaque and no pain, the doctor examined and diagnosed ORS. However, on the evening of the 4th day, an ambulance was called, the doctor suspected mononucleosis, the child was taking an antibiotic, they had a general blood test, a large number of leukocytes, mononuclear cells were within the normal range (as the pediatrician said), lymph nodes were enlarged. On the 7th day (today) they donated blood to detect early antibodies and the virus itself, the result will be ready in 2 days. The doctor gave a referral for hospitalization, and this worries us very much, since, of course, we don’t want to be with the child in the infectious diseases department. Can you please tell me how long you need to stay in hospital? The nose is disturbing (breathing is difficult), there is no runny nose!
Patients are hospitalized according to clinical indications. The main indications for hospitalization and treatment of a patient in a hospital are: prolonged high fever, jaundice, complications, diagnostic difficulties.
My baby is 1.6 months old. 4 days went to the nursery and fell ill with mononucleosis. For 7 days the temperature was under 40. We were admitted to the hospital. They pierced 7 days with antibiotics and continue to drink acyclovir. Now he is covered in pimples. What is it an allergy or so the disease is shown? What to do?
At the height of the disease, patients receiving antibiotics often develop an allergic rash. This is most often observed when prescribing penicillin drugs. Report this to your doctor.
A 3-year-old child has had infectious mononucleosis, after which he has ARVI every month. How does mononucleosis affect the immune system, which is the most effective treatment and prevention of consequences?
In our opinion, the cause of frequent episodes of acute respiratory viral infections in a child is not mononucleosis, but another reason (decreased immunity), which may have led to the fact that the child developed mononucleosis. Infectious mononucleosis does not have a long-term effect on the immune system and does not cause late complications. For the prevention of SARS, it is necessary to strengthen the immune system.
Tell me, please, a 14-year-old child has been ill with mononucleosis. How to determine if there are complications? Our friends advised us to donate blood for AST and ALT. is it necessary? And whether it is necessary to hand over on antibodies to mononuclear cells?
How long ago did your child have mononucleosis? Has the child been examined by a doctor? If the child has no complaints, there is no yellowing of the sclera of the eyes or skin, then the presence of complications of mononucleosis is practically excluded. You do not need to take any additional tests.
My granddaughter will be 6 in December. A diagnosis of mononucleosis was made. There was no high temperature. Now they said that the liver is enlarged by +1.5-2 cm. What should be the diet?
Next: good nutrition, including boiled meat, low-fat fish, vegetables, fruits, dairy products, cereals in the diet. Fried, fatty, spicy foods are excluded.
A 15-year-old boy suspected of infectious mononucleosis has been sick for 5 days: severe sore throat, nasal congestion, lack of appetite, severe weakness, headache, heat has been holding for 4 days (38.7-39.1). I knock down with nurofen (2 days), take zinnat (2 days), tantum-verde, nazivin, aqualor, rinse. Before nurofen, she knocked down panadol (2 days). On palpation, the liver is enlarged, white coating on the tonsils (fol. angina). Why does the temperature keep going up? Is it harmful to take Nurofen for more than 3 days? And how long can the high temperature last? Tomorrow we will hand over a general analysis of urine and blood.
It can last quite a long time (up to several weeks). Taking Nurofen for more than 3 days is not dangerous, but we recommend that you additionally consult with your doctor about this.
Six months ago, she was ill with infectious mononucleosis. She carried him on her feet, because she did not know. Then I just passed the tests for infections and found that I had been ill with them. There was a high temperature, cervical and occipital lymph nodes were enlarged. After that I felt fine. The infectious disease specialist said that I no longer need her treatment, and why the temperature is for other doctors to find out. I have now had a long-term sub-verity for six months. Malaise. Weakness. In the morning the temperature is 35.8, in the evening it rises. None of the doctors can say anything. And literally 3 days ago I also caught a cold. Ordinary ORV. But it is impossible to sleep at night, the lymph nodes on the back of the head and ear have increased. Now I don't know what it is. With what it is connected!!! Help me please!!
As a rule, infectious mononucleosis does not require specific treatment and always ends in recovery. The disease almost never recurs. After recovery, a person often has a weakened immune system and an increased susceptibility to other infections. There are many reasons for an increase in body temperature, therefore, diagnosis is possible only with direct contact with a doctor who will find out the presence of other symptoms, as well as prescribe additional studies.
Can you please tell me if it is possible to vaccinate DPT and polymelitis for children (3 and 6 years old), if they are diagnosed with infectious mononucleosis, cytomegalovirus, we have been treating these infections for 2 years, but to no avail. There is no acute phase now. Prior to this, the immunologist gave a medical tap once, when the acute phase was, and the hematologist all the time gives a medical tap. From the kindergarten they require either a medical discharge or vaccination. I know that these infections are practically impossible to cure, only poisoning the body of children with medicines. The last time the youngest was prescribed vitamins (he has constantly inflamed lymph nodes in his neck). Now a re-examination is needed. But I don’t want to go, because I know that the analysis will show the same thing, and the treatment is the same.
Vaccinations in this case can be done.
How can you quickly and effectively raise the immunity of a child after mononucleosis?
The immune system is too complex and finely structured system, and therefore it can be upset by any too sharp and active influences.
My 12 year old son had a severe form of mononucleosis in June. We are currently taking cycloferon. Recently, the child began to complain of strong frequent heartbeats. In a calm state, without physical exertion, the pulse can reach 120 beats per minute with blood pressure within 120/76 - 110/90. Cases of such strong heartbeat happen even at night. Can these symptoms indicate any complication after the illness? Or is it something else? And which doctor should I contact?
You should show the child to the pediatrician and cardiologist. Despite the fact that heart damage in mononucleosis is practically impossible, in this case, consultation with a cardiologist is still necessary.
Is it possible to get infectious mononucleosis again?
Recurrence is practically impossible.
My 12 year old son has mononucleosis. The acute stage of the disease has passed. Now we are recovering at home. I was constantly next to him, practically did not leave. I am 41 years old. Now I feel bad too. The temperature is kept at 37.3 - 37.8. severe weakness. Sore throat, nose intermittently does not breathe. Feeling that this pain and discomfort wants to move into the ears. The eyes were very reddened. Can I now become a carrier of this virus or get mononucleosis myself?
The symptoms you describe are not typical for mononucleosis and it is generally unlikely that you contracted this disease from a child. you may have an episode of a banal SARS common at this time of year (adenovirosis). We recommend to carry out symptomatic treatment colds folk remedies. If you notice the appearance of pain in the liver, swollen lymph nodes, or any other signs of mononucleosis, be sure to consult a doctor.
My 12 year old son was diagnosed with mononucleosis. The disease is severe. The temperature reached 40.4. The symptoms of this disease are removed by traditional means. At this point in time is the 6th day of illness. The temperature is kept within 38.3 - 39.5. I refuse hospitalization due to the fact that the child eats exclusively homemade food. Maintaining this condition in the hospital is not possible, due to the fact that appetite can occur at any time of the day with a decrease in temperature, even at night. Can I treat this disease while staying at home? What are the risks associated with this disease?
In most cases proceeds favorably, which makes possible treatment at home, but despite this, you should keep the child under the supervision of a doctor. The most dangerous complication of mononucleosis is rupture of the spleen, so make sure that for some time after recovery, the child refrains from active games that can lead to a fall or injury to the abdomen.
The article describes the disease - mononucleosis in children, symptoms and treatment, diagnosis, prevention and recommendations for patients during the treatment of the disease. 
What is infectious mononucleosis?
☝Mononucleosis is an infectious viral disease that resembles the usual respiratory infection, however, its flow affects the state internal organs. A characteristic sign of mononucleosis is the enlargement of the lymphatic glands of the body, especially the spleen. The disease also negatively affects the state of the respiratory system and liver.
The causative agent of mononucleosis is the Epstein-Barr virus, which affects mainly the lymphatic system of the body.
Epstein-Barr virus under the microscope The main risk group for this disease is boys of childhood and adolescence.
Adults rarely suffer from this disease. The disease has a short history, its causative agent was discovered relatively recently, so to this day the treatment is mainly symptomatic.
❗However, knowing the symptoms also does not always guarantee timely detection of the disease. There are frequent cases of atypical mononucleosis, when the symptoms are greatly smoothed or completely erased, and the disease is diagnosed by chance in the course of other studies. Mononucleosis, on the other hand, can manifest itself excessively.
Mononucleosis spreads mainly from person to person in everyday situations: eating from shared dishes, sneezing, coughing, kissing.
☝ Infectiousness greatly increases in institutions of a closed and semi-closed type - schools, kindergartens, sections, etc. Given that the disease most often affects children under 10 years of age, these places become the main source of the epidemic.
As already mentioned, in a considerable number of cases, the disease does not manifest itself in any way, but the person carrying the virus is still contagious to others. More than half of all patients experience only symptoms similar to the common cold, while statistical analysis of medical data suggests that up to 90% of adults are infected with the virus.
Infectious mononucleosis in an erased form
Ignoring the symptoms of mononucleosis and refusing timely treatment can lead to serious consequences that can even lead to disability or death. The specificity of the disease lies in the fact that no medicine has been developed against it, aimed at combating a specific pathogen, and all treatment comes down to maintaining the natural forces of the body and its immune system.
Symptoms of infectious mononucleosis
In most cases, it is impossible to say exactly from whom the virus was transmitted to a particular patient. The source of infection may feel completely healthy and not suspect that he is a carrier. In the meantime, you can get infected from it even during a normal conversation, or drinking tea from one cup.☹
The incubation period of the disease lasts from 5 to 15 days. Sometimes, with a combination of some factors of the characteristics of the patient's body, the incubation period can stretch up to one and a half months. Only then do clinical signs appear. As a rule, for such a period it is impossible to remember exactly with whom the child had potentially dangerous contact.
❗If parents know for sure that the baby has been in contact with an infected person, careful monitoring of his condition is required for a couple of months. If during this time no characteristic signs appear, it means that the immune system has coped with the disease.
The most common symptoms of MI Often the disease begins with a general intoxication, typical of any other viral disease - for example, influenza. The patient feels chills, weakness, rise in temperature. Characteristic are skin rashes and palpable lymph nodes. Such manifestations are a reason to immediately contact a pediatrician.
Symptoms of mononucleosis can be very diverse. Most often, the temperature rises quite quickly to subfebrile levels, a constant sore throat begins, difficulty breathing and swallowing - this is an indicator of an increase in tonsils. Visually, the throat is red, swollen, the nose is also blocked due to swelling of the mucosa.
The fever can last from a few days to a month. The temperature can rise to quite high levels. This is very debilitating for the child. The duration of the symptom depends on the individual state of the body, in particular the immune system, as well as the effectiveness of the treatment.
Temperature in infectious mononucleosis within 38 degrees In the first week (sometimes longer) the child is constantly shivering, weakness and drowsiness, headache, pain when swallowing and a feeling of aching muscles. At the same stage, at the beginning of the disease, a rash appears, which can be quite intense and spread throughout the face and body. It does not itch, does not cause any discomfort, does not require separate treatment - the rashes go away on their own in the treatment of the underlying disease.
The most important symptom of the disease is an increase in lymph nodes.
Enlargement of lymph nodes in MI They can change on any part of the body, are easily palpated, while the patient experiences pain. Polyadenitis occurs in the throat on the tonsils - deposits of a gray or white-yellow hue, which are easily removed, but are a sign of hyperplasia of the lymphoid tissue.
Rash on the body with MI ➡As already mentioned, mononucleosis also affects the endocrine glands. In particular, an enlarged spleen can lead to misdiagnosis and unnecessary surgery.
Diagnosis of the disease
As noted earlier, symptoms can vary in both manifestations and severity, so a pediatrician or an infectious disease specialist should focus not only on external manifestations, but also on laboratory parameters to make a diagnosis. First of all, a reliable diagnostic method is a hemotest, or a blood test - general, biochemical and specific antibodies.
Blood test detects mononuclear cells With mononucleosis, a pathological shift will be traced in the general blood formula, mainly a huge number of leukocytes due to the increased work of the lymph nodes. Also pathologically increased is the value of ESR - the erythrocyte sedimentation rate. It is also likely that atypical mononuclear cells appear in the blood formula - cells with an atypical structure, characterized by a large basophilic cytoplasm. The last sign is not on initial stage disease, and 2-3 weeks after its development.
➡The test for specific antibodies allows laboratory differential diagnosis with other diseases. This analysis is especially important in the atypical course of the disease. The analysis is carried out for IgM, IgG (immunoglobulins) and antibodies to the Epstein-Barr virus. Another option is PCR analysis, which also allows you to identify the exact type of infectious agent.
In addition, it is necessary to conduct an ultrasound of the organs abdominal cavity, especially paying attention to the condition of the liver and spleen. This will help to assess their condition and choose a symptomatic treatment that will preserve the functionality of these organs, avoiding surgical intervention.
The PCR method is one of the most accurate
✔ In addition, it is necessary to repeat serological tests within several months, which will allow to differentiate laboratory indicators of mononucleosis from HIV infection (these conditions have a similar picture in the blood test).
Treatment of mononucleosis in children
Mononucleosis is a viral disease, so the use of antibiotics against it is meaningless. There is no single medicine for the treatment of mononucleosis; various antiviral agents are used in therapy (Acyclovir, Isoprinosine, etc.). However, the main forces to fight the virus come from the body's natural immunity, and the higher it is initially, the more chances for a quick recovery without complications.
☝☝☝Children's doctor Komarovsky says that acute mononucleosis is a disease that in most cases is treated on an outpatient basis, i.e. at home with regular visits to the doctor.
However, in severe cases (especially for infants), hospitalization of the child in the hospital is indicated. The admission criteria are as follows:
- The temperature is above 39.5 C;
- Development of complications;
- Pronounced signs of intoxication of the body - vomiting, nausea, prolonged fever, etc.;
- Severe breathing difficulties, threat of suffocation.
There are various ways to treat mononucleosis. As mentioned earlier, the first method of therapy is symptomatic, designed to eliminate the manifestations of the disease, while the body's immunity fights the virus on its own. The drugs used for this purpose are mainly antipyretic drugs.
In the event that mononucleosis gives a complication in the form of a sore throat, local antiseptics are used, and immunomodulatory non-specific drugs are also prescribed to maintain the body's defenses. Antibiotics orally or by injection are prescribed only if a bacterial infection is attached and it is detected in the tests.
Often, the treatment of mononucleosis is accompanied by the appointment of fortifying vitamin agents, because. the body loses many useful substances during the fight against the disease. Hepatoprotectors and other drugs are also used to improve liver function. To avoid allergic reactions in response to a decrease in immunity, antihistamines are prescribed.
In the case of a severe course of the disease with clear signs of toxicosis, a short-term course of prednisolone is prescribed in a hospital. The drug is also used for high risk asphyxia. Also, with swelling of the larynx and severe breathing difficulties, a tracheostomy is installed, and the child is transferred to artificial ventilation.
Another dangerous complication of mononucleosis is rupture of the spleen. To avoid this, ultrasound monitoring of the state of the organ is regularly carried out, and in case of a rupture, a surgical operation is necessary.
☝You can often meet people who recommend treating mononucleosis with homeopathy. Including you can meet people who give positive feedback about such treatment. The popular rumor about the benefits of homeopathy is explained by the fact that the remedies themselves do not make the body either better or worse, and mononucleosis is sometimes cured on its own, provided that the child has strong immunity.
However, with such treatment, a complication can easily develop, which in turn threatens with consequences up to death.
As noted above, mononucleosis causes dysfunction of the liver and spleen. Therefore, during the treatment period, it is important to follow nutritional recommendations and follow a therapeutic diet. It is recommended to exclude the following foods from the diet:
- Sweet soda;
- Hot sauces, ketchup, mayonnaise;
- Coffee, cocoa, chocolate;
- Meat broths;
- Fatty meat dishes;
- Spicy dishes, seasonings, canned and pickled foods.
It is preferable that the diet is varied and the portions are small. It is advisable to eat boiled dietary meat, cereals, broths on poultry or vegetables. It is important that the child consumes a lot of liquid - it can be both ordinary water and compotes, fruit decoctions, juices diluted in a small concentration.
It is advisable to give the patient sweet fruits, cereals, dairy and sour-milk products, fish, rabbit, chicken. It is better if the food is crushed or served in a semi-liquid state. As a drink, warm weakly brewed tea or herbal decoctions are also suitable.
In the first days of acute onset of symptoms, the child may not have an appetite at all. In this case, you should not force-feed him, it is only important to ensure that he drinks enough fluids, especially if fever and vomiting are present in the symptoms.
⚠Children are easily dehydrated, and fluid imbalance negatively affects the course of the disease.
Possible complications and prevention of the disease
First of all, mononucleosis can cause complications in the work of those organs on which it has the greatest negative effect - the liver and spleen. With a prolonged or severe course of the disease, the patient may develop hepatitis, liver failure (especially in the case of a previous pathology), and the spleen may rupture due to excessive enlargement. In order to avoid these consequences, with a significant severity of symptoms, it is desirable to carry out treatment in a hospital, under the supervision of doctors.
Complications - hemorrhage In addition, with reduced immunity, mononucleosis can cause complications in the form of meningoencephalitis, bleeding, and chronic tonsillitis. In addition, it should be borne in mind that immunity to mononucleosis is not formed, i.e. she cannot get sick again, tk. the virus remains in the human body for life, being in an inactive form. However, in this case, the patient acts as a carrier and can infect others.
There is no cure for mononucleosis as such.
When registering an outbreak of the disease, it is necessary to isolate patients from staying in groups (especially if these are preschool institutions), because. the disease can be transmitted by contact-household. All other recommendations relate to maintaining the normal state of the immune system - regular exercise, exposure to fresh air, healthy eating and timely treatment of infections.
An important step in maintaining immunity is the competent alternation of sleep and wakefulness and sufficient duration. This is especially true for schoolchildren and students. It has been proven that lack of sleep, like a fragmented regimen, reduces the body's natural defenses.
In a word, there is no universal vaccine or medicine that can protect a child from mononucleosis, however, with the right attitude to one's health, natural defense mechanisms will help to avoid infection, or transfer it with minimal risk of complications.
Infographics - symptoms, diagnosis, treatment
Save your infographic Mononucleosis- an infectious disease, which is characterized by many different symptoms, which is why treatment in children differs.
It is very important not to miss the moment of development of complications that distinguish this disease from the common cold.
A special role in the cure is played by dietary immunostimulating nutrition.
Therapist: Azaliya Solntseva ✓ Article checked by Dr.
Symptoms and treatment of mononucleosis in children
The pathology is often called kissing disease, due to the typical route of entry. The Epstein-Barr virus that causes this disease is transmitted through saliva, so you can become infected through coughing or sneezing, as well as by sharing utensils with a sick person. However, mononucleosis in a child is not as contagious as some common infections such as the flu and tonsillitis.
Epstein-Barr virus disease usually occurs in infancy and remains latent throughout life.
Teenagers are more at risk of developing the disease. Young children usually have fewer symptoms and the infection often goes unrecognized.
In the presence of pathology, it is important to be careful with some complications, such as enlargement of the spleen and liver. Rest and adequate fluid intake are key to recovery.
Symptoms and signs of pathology
Signs and symptoms of mononucleosis in children may include:
- a sore throat;
- possible development of streptococcal lesions (tonsillitis), which does not go away with the use of antibiotics;
- headache;
- skin rash;
- fever;
- soft and enlarged spleen;
- swelling of the lymph nodes in the neck and armpits;
- fatigue.
The incubation period for the virus is approximately four to six weeks, although it may be shorter in young children. Signs and symptoms, such as fever and sore throat, usually improve within 12 to 14 days, but other symptoms such as fatigue, swollen lymph nodes, and a swollen spleen may persist for several weeks longer.
How to treat the disease
Infectious mononucleosis is a disease that usually does not require special treatment in mild to moderate patients. However, if the tonsils are markedly enlarged or the child's symptoms persist for a long time (severe thrombocytopenia or anemia), most doctors recommend a short course of steroids (1-2 mg/kg prednisone daily for 3-7 days).
Due to the low infectivity of the Epstein-Barr virus, isolation of the patient is not needed. Since most patients can be treated on an outpatient basis, i.e. in the clinic, then therapy in the clinic is required only if there are complications.
Non-steroidal anti-inflammatory drugs (diclofenac) are used to treat fever and discomfort. New therapies are being explored, including the use of interferon-alpha and infusion of donor T cells.
www.emedicine.medscape.com
www.mayoclinic.org
Viral mononucleosis - manifestations
This infectious process was first described in the late 19th century as acute glandular fever, a disease that includes lymphadenopathy, fever, enlargement of the liver and spleen, and abdominal malaise and discomfort.
The Epstein-Barr virus is a type of herpesvirus that infects more than 95% of the world's population. The most common manifestation of primary infection is mononucleosis.
Classic symptoms include sore throat, fever, and lymphadenopathy (inflammation of the lymph nodes). Infection in young children is usually asymptomatic or mild. Epstein-Barr virus is also a tumor factor associated with human malignant neoplasms (oncological pathologies).
The incidence of acute infectious mononucleosis was approximately 45 cases per 100,000 people per year in the early 1970s, with the highest incidence in those aged 15–24 years. However, changes in economic status have led to the disease appearing at an earlier age.
The incubation period in adolescents is 30-50 days, while in young children it is less. The course of acute infectious mononucleosis is 1-2 weeks of fatigue and malaise; however, the onset can be acute.
Viral mononucleosis in children manifests itself in the form of sore throat, abdomen, head, fever, myalgia, and nausea. The severity of manifestations depends on many factors. Sore throat is the most common symptom.
The patient's condition gradually worsens over the course of seven days and is described by patients as the most unpleasant illness in life. Headache usually occurs within the first week and is felt behind the eye sockets.
Discomfort in the left upper abdomen may be caused by an enlarged spleen. Symptoms usually persist for 2-3 weeks, but the fatigue stays longer.
The disease often resolves without any symptoms in infants and young children. On examination, there may be sore throat (pharyngitis), enlargement of the spleen, liver, cervical and axillary lymph nodes. In children under 4 years of age, there is inflammation of the abdominal organs, a rash, and symptoms of infection of the upper respiratory tract.
www.emedicine.medscape.com
Consequences and complications
Most primary Epstein-Barr virus infections are asymptomatic. This is the most common cause of fever of unknown origin in young children. Fever may be isolated or associated with symptoms such as lymphadenopathy (inflamed lymph nodes), fatigue, or malaise.
Deaths are uncommon, but may occur due to neurological complications, obstruction (obstruction) of the upper airway, or rupture of the spleen.
The infection is associated with numerous tumors. Burkitt's lymphoma, the most common childhood malignancy in Africa, is associated with the Epstein-Barr virus and malaria. In Asia, this virus has been associated with the development of nasopharyngeal carcinoma (cancer).
Mononucleosis often leads to an enlarged spleen. In extreme cases, the organ may rupture, causing sudden, sudden pain in the left upper abdomen. If this occurs, you should immediately consult a doctor, as surgery may be required.
Liver problems are also possible: hepatitis (inflammation of the liver tissue) and jaundice.
Consequences of mononucleosis in children and possible complications:
- anemia - a decrease in the number of red blood cells and hemoglobin levels;
- inflammation of the tonsils, which can cause obstruction (impaired patency) of the airways;
- meningitis and encephalitis;
- heart problems - inflammation of the heart muscle (myocarditis);
- thrombocytopenia - low content cells - platelets, which are involved in blood clotting.
The virus can cause much more serious condition in children with weakened immune systems.
www.mayoclinic.org
www.emedicine.medscape.com
Rash with mononucleosis in children
Usually mild, widely scattered. The rash mostly looks like flat spots with small red patches. The rash develops first on the trunk and shoulders, soon spreading to the face and forearms, mainly on the flexor surfaces of the arms. Appears quickly and disappears in the same way.
Occurs in 3-15% of patients and is more common in young children. There is usually slight itching.
Treatment of mononucleosis in children with amoxicillin or ampicillin causes a rash in about 80% of infants. Often occurs when a primary Epstein-Barr virus infection is initially misdiagnosed and treated as strep throat.
www.emedicine.medscape.com
www.doctordecides.com
Baby blood test
The three classic criteria for laboratory confirmation of an infectious process include: leukocytosis, the presence of more than 10% of abnormal lymphocytes in a smear, and positive result serological test for Epstein-Barr virus.
Antibody tests. This analysis provides results within a day. But he cannot detect the infection during the first week of illness. If further confirmation is needed, a mononuclear spot test can be done to test the blood for Epstein-Barr virus antibodies.
It takes longer to get a result, but can detect the disease even within the first week after the onset of symptoms.
The doctor may use other blood tests to look for elevated cell counts or abnormal-looking lymphocytes. These studies do not confirm mononucleosis, but may suggest it.
www.mayoclinic.org
www.emedicine.medscape.com
How the disease is transmitted
Epstein-Barr virus is the cause of 90% of cases of acute infectious mononucleosis. Other pathogens can also cause this disease. Generally, viruses are spread through body fluids, especially saliva. However, they can also be transmitted through blood transfusions and organ transplants.
The only predisposing risk factor for pathology is close contact with a person infected with the virus.
It usually persists in the nasopharyngeal secretions for several months after the disappearance of the symptoms of the disease. Patients with congenital immunodeficiencies (especially children) are predisposed to the appearance of malignant tumors.
The virus can be spread by sharing items such as Toothbrush or a glass of drinking water. Since the virus is transmitted through bodily fluids, it survives on the object as long as its surface remains wet.
When first infected, a child can shed the virus for several weeks, even before symptoms appear. When the infection is in the body for a long time, it remains in a latent (inactive) state. If the virus wakes up, the child becomes a carrier of the disease, no matter how much time has passed since the initial infection.
www.emedicine.medscape.com
Proper therapeutic diet
Diet is one of the first things to change after an Epstein-Barr virus infection to prevent worsening of symptoms.
Products with fatty acids should be added to the diet to help reduce inflammation: avocados, nuts, seeds and fish.
Drink plenty of fluids. Fever is one of the first symptoms of mononucleosis and can lead to dehydration especially in infants. Make sure that the child drinks enough water, juices and compotes. Drinking lemon can help relieve the sore throat that usually accompanies mononucleosis.
Fruits and vegetables are high in antioxidants that can help the immune system fight viruses and infections and flush out toxins from the body.
Protein-rich foods support cell health and stimulate body repair. These include: chicken, fish, eggs, lean meats, and tofu. The diet should not be concentrated on one product, for example, an excessive amount of protein in the diet can lead to other problems.
There are certain foods that should be avoided due to possible negative effects on the body:
- Too much sugar and carbohydrates. Excess glucose in the diet increases inflammation. Refined foods such as white bread should also be avoided because they are also converted into glucose in the intestines.
- Caffeine can increase fatigue by slowing down the recovery of the body.
- Alcohol. The Epstein-Barr virus directly infects the liver. Remember that drinking alcohol while you have symptoms of mono can damage your gland.
www.articles.mercola.com
How antibiotics work
There is no specific therapy for infectious mononucleosis. Antibiotics do not work against these viral diseases. Treatment is mainly related to bed rest, good nutrition and plenty of fluids.
Sometimes a streptococcal infection accompanies the underlying illness. Sinusitis (inflammation of the paranasal and frontal sinuses) or infection of the tonsils (tonsillitis) may develop. In this case, the child may need antibiotic treatment.
Amoxicillin and other penicillin derivatives are not recommended for children with mononucleosis, as they may develop a rash. However, this does not always mean that they are allergic to the antibiotic. Other antimicrobial agents that are allowed to treat pathology are less likely to cause changes in the skin.
www.mayoclinic.org
Symptoms without fever
There may be a disease without fever and marked enlargement of the lymph nodes. The most common symptom in this case is fatigue, but even that is not always present. Thus, the diagnosis cannot be ruled out due to the absence of any particular manifestation.
Mononucleosis will often present like a common viral infection early in the illness and without fever. Significant symptoms gradually develop to help distinguish the condition.
A key feature of the pathology is that it lasts longer than ordinary tonsillitis or tonsillitis.
A traditional blood test is usually negative during the first week of illness. Specific antibody tests may show a positive result sooner, but most doctors usually do not do such tests during the first week of illness.
If symptoms improve within 2-5 days, it is a common cold. Otherwise, it's most likely mononucleosis.
www.justanswer.com
Atypical type of pathology
The disease can proceed in an unusual form. In this case, the child does not experience typical symptoms of the disease, such as: sore throat, fever and lymphadenopathy (swollen lymph nodes). Manifestations that are not specific come to the fore: soreness in the chest during inspiration, discomfort in the abdomen, especially in its upper half, jaundice, which is characteristic of calculous cholecystitis.
A different combination of symptoms is possible, which makes it difficult to diagnose and treat the disease. In older children, atypical mononucleosis may present as hepatitis or myocarditis (inflammation of the heart muscle).
Various diseases of the upper respiratory tract in children often have a similar clinical picture. In some cases, fever and catarrhal symptoms indicate infection with the Eppstein-Barr virus (EBV), which causes infectious mononucleosis in a child.
Causes of the disease
Herpes virus type 4 - the cause of mononucleosis - is very common, according to various sources, 85-90% of the adult population of the planet is infected with it. Half of the children under five also had contact with the pathogen. Children 3-10 years of age are most susceptible to the virus. The source of infection is the patient, in the saliva of which there are pathogens. Sneezing, coughing, sharing utensils, kissing can lead to the transmission of the pathogen to the child.
Infection occurs through the upper respiratory tract. The incubation period lasts 5-15 days, in some cases up to a month. The virus prefers lymphoid tissue. It penetrates into the lymph nodes, where it begins to multiply in the cells of B-lymphocytes.
Signs of a pathological condition
The disease begins with a feeling of general malaise, weakness, which lasts for several days. Then the temperature rises to 38–40 degrees. The following symptoms of mononucleosis in children can be noted:
- sore throat;
- nasal congestion;
- painful swallowing;
- an increase in the submandibular and cervical lymph nodes;
- increased sweating;
- muscle aches;
- headache.
On examination, the epithelial membrane of the pharynx is hyperemic, the tonsils are enlarged. At this stage, mononucleosis can be mistaken for a sore throat, but with sore throat there is no nasal congestion and purulent plaques appear on the tonsils.
The main symptom of the disease is polyadenitis - an inflammatory reaction of the lymph nodes.
Initially, the lymph nodes on both sides of the neck are affected. They become bumpy and are clearly visible when moving the head. Peripheral lymph nodes are also affected by the virus, a manifestation of this is their hyperplasia. Axillary, inguinal, as well as nodes of the abdominal cavity may increase. The latter compress the nerve endings, which leads to an acute abdomen and makes diagnosis difficult. On palpation, the lymph nodes are smooth, firm, painful, and mobile.
The liver and spleen are enlarged. Stretching of the Glisson capsule that covers the liver causes a dull aching pain in the right hypochondrium. Children complain of abdominal pain. danger sign- Enlargement of the spleen. In some cases, from a small physical activity or spontaneous rupture of the spleen. The condition is manifested by symptoms of acute bleeding into the abdominal cavity:
- sharp pain in the abdomen;
- tachycardia;
- drop in blood pressure;
- pallor and cold sweat.
With an increase in temperature, a rash appears on the body of the child. The intensity of the rashes can be different. Elements in the form of red-pink spots are localized on the face, body, limbs. The rash does not itch and goes away without special treatment as you recover. The reason for the strengthening of the symptom may be improper treatment. If infectious mononucleosis was mistaken for a sore throat and began to be treated with antibiotics - penicillin derivatives (Amoxicillin, Augmentin), then this can lead to increased rash, itching.
Very rarely, mononucleosis is accompanied by jaundice, which indicates serious liver damage.
The acute and most contagious period of the disease lasts up to three weeks.
In infants, the disease occurs much less frequently. They are infected from the mother during kissing and breastfeeding: the virus enters the milk. A newborn baby can become infected while passing through the birth canal. Symptoms of the disease in infants are less pronounced.
Mononucleosis can cause the following complications:
- hepatitis;
- immunodeficiency;
- pathology nervous system;
- myocarditis;
- pneumonitis;
- chronic fatigue syndrome.
At an older age, with a pronounced weakening of the immune system, the consequences of the herpes virus type 4 can be Burkitt's lymphoma, lymphogranulomatosis, and nasopharyngeal cancer.
Diagnostics
Clinically, the diagnosis of mononucleosis is confirmed laboratory diagnostics. General analysis blood is its first stage. Changes in it relate to the appearance of atypical cells - mononuclear cells, or wide plasma lymphocytes. These are cells affected by EBV. By external signs, they are easily recognized by an experienced laboratory assistant. With mononucleosis, the number of atypical mononuclear cells reaches 10% or more. Normally, these cells should not be. It also increases the erythrocyte sedimentation rate, which is normally 1–9 mm/hour, and the total number of lymphocytes. 
To assess the general condition, a biochemical blood test is prescribed. It controls the level of bilirubin, ALT, AST, alkaline phosphatase, the change of which indicates violations of the liver.
Ultrasound of the liver and spleen is necessary to assess their condition, degree of enlargement.
Serological diagnostics allows you to reliably determine the pathogen and the stage of the infectious process:
- Determination of antibodies to the Epstein-Barr virus. At the height of the disease, the concentration of IgM in the blood serum increases. If only anti-EBV IgG antibodies are found in the blood, then this indicates a past illness.
- Laboratory in the blood serum determine the capsid and membrane antigens - viral proteins.
- PCR diagnostics is aimed at searching for virus DNA in saliva, blood, or scrapings from the oral mucosa.
Therapeutic techniques
If you have a fever and sore throat, you need to call the pediatrician at home. In most cases, hospitalization is not needed. It requires the following indications:
- prolonged fever above 39.5 degrees;
- threatening asphyxia;
- complications. For example, severe liver and spleen lesions are treated in the hospital.
At home, symptomatic therapy is carried out. Antipyretics are taken against fever. Children are allowed Ibufen and Paracetamol. Aspirin is prohibited for children under 12 years of age: it can lead to the development of Reye's syndrome - a special type of acute liver failure. If the temperature does not go astray, the doctors of the clinic or ambulance can give an injection with a mixture of Diphenhydramine and Drotaverine. In the hospital, droppers are prescribed for this purpose.
The throat is treated with antiseptic solutions: Furacilin, Chlorhexidine, Miramistin, decoctions of chamomile and calendula. The elements of the rash do not need to be lubricated.
Hypersensitivity to a foreign organism is removed with antihistamines: Phencarol, Cetirizine, Suprastin.
Antiviral drugs Acyclovir or Ganciclovir are prescribed only for severe or recurrent disease. They have a greater effect when administered simultaneously with immunomodulators: Viferon suppositories, Isoprinosine tablets, children's Anaferon.
Antibiotic therapy is prescribed only by a doctor when a secondary bacterial infection is attached. Vitamins are essential for overall health.
The hypertoxic course of mononucleosis requires the appointment of a course of prednisolone. With its help, asphyxia is also eliminated. In severe swelling of the larynx, a tracheostomy is installed - a temporary tube into the trachea to facilitate ventilation of the lungs. If the disease is complicated by rupture of the spleen, an emergency operation is performed to remove it.
The day regimen of a sick child should include enough time for rest and sleep; bed rest is preferable at home in the acute phase. The diet should be sparing and balanced. It is worth avoiding fatty, fried, too salty and sweet foods, carbonated drinks, so as not to additionally burden the liver.
Recovery after illness
It is impossible to completely cure the herpes virus type 4. The infection remains dormant in the child's body. During the year, children who have been ill are subject to dispensary observation. After the illness, the health of the child is restored gradually. Within a month, the lymph nodes decrease. Weakness and fatigue can persist for up to six months. Within a week or two after the disappearance of clinical signs, physical activity and heavy lifting should be limited to exclude rupture of the spleen. Re-infection with mononucleosis does not occur, the disease leaves behind stable lifelong immunity. 
Specific prophylaxis against EBV has not been developed. You can reduce the risk of infection if you carry out wet cleaning of the premises and airing where there are large groups of children. The same rule applies at home, especially during the season of the rise in the incidence of SARS.
Doctor Maria Nikolaeva
Mononucleosis is a disease that occurs when children are infected with the Epstein-Barr virus (). Infection causes symptoms characteristic of SARS. Intensity clinical picture in this disease depends on the state of the immune system. The latter also determines the probability of development dangerous consequences mononucleosis in children.
Infectious mononucleosis is acute illness caused by herpes virus. The risk zone for infection includes children aged 3-10 years. Less common in adolescents. In extreme cases, the infection enters the body and manifests in adults.
When examining a child in the blood, a high concentration of atypical mononuclear cells (a type of white blood cell) is detected. After entering the body, the infection affects the lymphatic system, liver and spleen.
Infection of a child with the Epstein-Barr virus occurs in the following ways:
- airborne (the virus is transmitted through kissing, during sneezing, coughing);
- through household items;
- through the blood from mother to child during pregnancy.
The transmission of the virus often occurs in the children's team. The duration of the incubation period depends on the state of immunity. On average, from infection to the first signs of the disease, 7-30 days pass. In most patients, mononucleosis is mild.
The danger of the disease lies in the fact that many children have no pronounced symptoms. However, the carrier of the infection remains contagious to the environment. With a latent form of mononucleosis, mild symptoms of colds may appear.
Parents should be aware that the risk of contracting herpes virus increases in the autumn-spring period. This is explained by the fact that at the indicated time the body's resistance to the effects of the external environment decreases. To avoid infection, children in the autumn-spring period are recommended to be transferred to a healthy diet rich in vitamins.
Pathogen
The development of infectious mononucleosis in children occurs after infection with the Epstein-Barr virus. The latter enters the body through the mucous membranes. The causative agents of infectious mononucleosis are embedded in the cells of the nervous system, and therefore type 4 herpes remains “inaccessible” to immune attacks.
In a normal state, the body suppresses the virus. Under the influence of provoking factors that weaken the immune system, the infection is activated and provokes an exacerbation of infectious mononucleosis, and in adults - chronic fatigue syndrome.
Epstein-Barr virus (EBV) in children: symptoms (temperature), consequences, prevention, vaccination