Mononucleosis in adults. Symptoms and Treatment. Infectious, viral, chronic, atypical. How dangerous is transmitted, looks rash, blood tests, the effects of

Mononucleosis - a fairly common disease that affects the lymphatic system, spleen, liver and blood. It is a viral disease caused by one or more viruses of the family Herpesviridae. In 40% of this monoinfection, with 60% of them the culprit - Epstein-Barr virus.

In addition it can be agents of cytomegalovirus, herpes virus type 6. Symptoms of mononucleosis in adults are similar to the common cold and sore throat. But the treatment is completely different.

Understanding disease

Mononucleosis in adults, symptoms and treatment is determined by the agent, it is a syndrome and not a specific disease. His reasons may be effects on the body several herpes viruses. In 40% of cases, this mixed-disease, that is, an infection caused by several viruses at the same time.

But the etiology of him alone.

The virus enters the body via the mucosa of the nasopharynx and oropharynx and affects their lymph nodes. As a result of increased cervical lymph nodes. The virus infects lymphocytes. A distinctive feature is that the cells do not die, and modified. A small part of the virus continues to actively proliferate, and the rest remains in a latent state.

Inside the body the virus is spread and hematogenous lymphogenous ways and affects the entire lymphatic system, liver and spleen.

Classification

Mononucleosis in adults (symptoms and treatment depend on the causative agent) has the following classification:

• Epstein-Barrvirusny;
• cytomegalovirus;
• caused by herpes virus type 6;
• mixed infection, that is caused by several types of viruses.

According to the severity of the disease mononukleoznaya infection is:

• Easy. It characterized by low body temperature (around 38 °), which holds up to 5 days, a small increase in the cervical lymph node groups. Recovery from such an infection occurs within 2 weeks.
• moderate severity. The body temperature is kept to 8 days and amounts in the area 38,5 °, lymphadenopathy reaches intraabdominal lymph nodes, the liver is increased. The disease lasts 3 - 4 weeks.
• Severe. It characterized by high body temperature (39,5 ° and above), which holds more than a week, fever, considerable increase in tonsil, liver and spleen, lymph node all groups. Such mononucleosis lasts at least a month, and can cause various complications.

Sickness mononucleosis type is divided into:

• Typical, that is, there are specific to mononukleoznoy infection.
• AtypicalThat is, the disease progresses with uncharacteristic symptoms. It can be erased, subclinical and visceral. When erased mononucleosis symptoms are very weakly manifested. The presence of mononucleosis may indicate weakness, discomfort in the throat, slight fever, mild swelling of the lymph nodes zadnesheynyh. Nasopharynx, oropharynx, liver, spleen, remain practically unchanged. In subclinical (chronic) form mononucleosis detected only after carrying out a diagnosis, as it may extend entirely asymptomatic. Symptoms of visceral mononucleosis pronounced. Observed fever, high body temperature (above 39,5 °). Very often superimposed secondary infection, resulting in possible severe complications. This type is a severe form of the disease.

Depending on the duration of an infection disease mononukleoznuyu distinguished:

• Acute. Duration of disease was from 3 months.
• Protracted. The disease lasts from 3 to 6 months.
• Chronic. The disease lasts more than 6 months.
• Recurrent. If such an infection occurs the return of the primary symptoms some time after recovery (maybe a month, maybe a year).

By the nature of the disease mononucleosis distinguished:

• smooth, that is, without complications;
• non-smooth. This course of the disease may be associated with complications, with superimposition of a secondary infection, with acute exacerbation of chronic disease with relapses.

The timing of infection is isolated:

• Primary infection.
• Reactivation of latent infection. Mononukleoznoy virus infection, once in the human body once, it remains there forever. And from time to time depending on the state of the immune system, it can manifest itself again and again.

transmission path

A large amount of virus is in the saliva. Even after full recovery saliva is filled with agents of mononucleosis. They can be kept in them to 1 - 1.5 years after recovery. Herpesviruses also penetrate into the blood, but from it they disappear faster than from the saliva (in a couple of months after an illness).

In this regard, mononucleosis can spread:

• by droplets;
• transplacental route (from the mother to the fetus through the placenta);
• by contact via saliva (in particular, through the kissing);
• transfusion method (in contact with infected blood, including transfusion);
• through breast milk. Thus transmitted mononucleosis caused by Epstein-Barr virus or cytomegalovirus.

Symptoms of acute infectious mononucleosis

The incubation period mononukleoznoy infection is 2-7 weeks, generally 45 days.

During the first 2-5 days of illness, and sometimes up to 2 weeks may manifest symptoms of the initial stage (prodrome):

• general weakness;
• headache;
• slight indisposition;
• myalgia;
• fever.

These symptoms are often confused with the common cold or flu.

The following are common symptoms observed in the active stages of the disease:

• fever;
• fever;
• a sore throat;
• hindered nasal breathing;
• snore.

Mononukleoznoy local symptoms of infection are:

• lymphadenopathy - swollen lymph nodes. The first increase zadnesheynye lymph nodes. They can grow up to 2 - 3 cm. When the feeling they are rather compact, plastic, slow-moving. The remaining lymph nodes is increased by 1 - 2 cm in diameter. Growth is observed within 1 - 2 weeks, then stops and starts reducing them. Its full size of the lymph nodes can reach in about a year. Increased lymph nasopharyngeal causes shortness of nasal breathing.
• swelling, redness of the tonsils, uvula, and arches. There may be a continuous coating or island tonsils whitish-yellow or dirty gray bloom. Due to the great swelling of the tonsils may contact with each other. The result is siplost voice, snoring.
• Splenomegaly - enlargement of the spleen. It occurs in 50 - 65% of the patients in the first 3 weeks of illness. Palpation spleen edge protrudes by 2 - 3 cm from the arc hypochondrium.
• hepatomegaly - enlargement of the liver. It occurs in 30 - 50% of patients, while 5% may be observed jaundice.
• Rash - an optional sign. It occurs in only 3 - 15% of patients. Most often localized rash on the trunk. It can be of various kinds, but mostly fine, similar to measles. It lasts 10 days.

Symptoms of chronic mononucleosis

Chronic mononucleosis - an infection that lasts more than six months. It is typical for adults with weakened immune systems. Part of viruses continue to be inside the body at rest and after successful treatment. Thus, a person immune to it. But with a weakened immune system, the virus can re-assert themselves.

The nature of the symptoms	symptoms
Common symptoms of chronic infection mononukleoznoy	Fatigue; The decrease in performance. sleep disturbance, drowsiness, or vice versa. Headache. A small increase in the body (in the area of ​​37,2 - 37,5 °). Muscle pain. Depression. Weakness. Cold
local symptoms	Weak, aching pain in the throat (because chronic mononucleosis usually affects people infected with multiple herpesviruses may discharge of pus from the tonsils in the morning. Nasal congestion. Limfodenit in the cervical spine in a slight degree. There may be pain when turning head while chewing. A small swelling of the upper part of the face. Small, compared with symptoms of acute mononucleosis, enlarged liver and spleen

Unlike angina

Mononucleosis in adults, symptoms and treatments which may be confused with angina, often called mononukleoznoy angina. Symptoms and the clinical course of these two diseases are very similar. But their treatment is completely opposite from each other. Therefore, proper diagnosis is important.

differences:

• Angina - a bacterial infection and mononucleosis - viral. Therefore, for the treatment of angina using antibiotics. If mononucleosis, these drugs do not give any result.
• Angina can become infected primarily by children and adults. Mononukleoznoy ill infection mainly in children, in adults it manifests itself in the chronic form.
• If mononucleosis swollen nasal lymph nodes, causing nasal congestion, runny nose. When angina suffers only the throat, runny nose missing.
• If mononucleosis tonsils swollen, enlarged, with touch, which can be easily assembled spatula. When monoinfection not observed purulent education. Angina is accompanied by swollen red tonsils with suppurations. Pus can be represented as white dots, but can cover fully amygdala. When you press the spatula pus comes out easily.
  
• The composition of the blood with mononucleosis increase in lymphocytes is observed, and angina - neutrophils.

Diagnosing mononucleosis in adults

Mononucleosis Diagnosis depends on the type of disease.

Basic techniques for diagnosis:

• Anamnesis and survey. It reveals whether the person has previously been ill mononucleosis, whether in contact in the last 2 months with such patients.
• Visual examination of the patient. Looks around the throat, nose and skin. Carried palpation lymph nodes, liver and spleen.

Laboratory analysis:

• General blood analysis. With this method revealed the presence of atypical nuclears, increased lymphocytes. Atypical nuclears appear at 2 weeks and appear quickly. Therefore, the assumption in the mononucleosis KLA carried out every 3-4 days.
• Blood chemistry (Detected decrease platelet and neutrophil counts).
• General urine analysis. There is an increase of bilirubin, total protein.
• Linked immunosorbent assay (ELISA). It defines the antibody marker that confirmed the presence of virus antigens in the blood. The incubation period of 4-6 weeks and detected antigen Anti-VCA IgM. With 2-4 weeks of illness present nuclear nuclear antigen Anti-VCA IgS. This antigen is present in the blood up to the end of human life. The visceral form of mononucleosis is formed Anti-EA IgG. It disappears after 3-6 months after the disease. Also present in the blood antigen EBV (EBNA), which appears to only 2-4 months and remains for life.
• Polymerase chain reaction (PCR). This method makes it possible to identify the virus in the blood and saliva.
• ultrasound kidney and liver.

In a typical course of the disease serological diagnostic methods (ELISA and PCR) can be omitted. When erased and subclinical disease, be sure to conduct all methods.

In the case of visceral diseases further conducted screening for complications:

• tests for bacteria;
• X-rays of light;
• electrocardiogram (ECG);
• electroencephalogram;
• tests for hepatitis B;
• Ultrasound of the affected organs.

In addition, the obligatory consultation of a hematologist, a dermatologist, ophthalmologist, infectious disease specialist, a neurologist.

medication

Mononucleosis in adults treated symptomatically. Treatment assigned individually, depending on the symptoms, age of the patient, his general condition and portability of pharmaceuticals.

For the treatment of the following drugs are used:

• Antipyretics: Ibuprofen, Nurofen, Efferalgan, Paracetamol. You can not use aspirin.
• Antiseptic gargle: Miramistin, Chlorhexidine, furatsillina, Chlorophyllipt.
• Antivirals: interferons and their inducers, Groprinosin.
• Immunoukreplyayuschie means: Viferon, Immudon, TSikloferon, Isoprinosine, IRS-19.
• Anti-inflammatory and Allergy medicines: Prednisone, Dexamethasone. To eliminate the inflammation in the throat Lugol used, Lizobakt, Septefril.
• Multivitamins.
• Drops in the nose to remove nasal congestion: Polydex, xylometazoline.
• Antibiotics. They are assigned only in case of purulent processes. Typically, fluoroquinolones are used. Ampicillin, Amoxiclav, Flemoksin soljutab can cause a rash. In this complex appointed probiotics: Linex, Atsipol, Beefy-forms Bifidumbacterin.
  
• Drugs that support liver function: Supraks, Ceftriaxone.
• If you have problems with the digestive system, and pancreas assigned Creon 1000 cholagogue drugs.

ethnoscience

In mild disease against mononucleosis effective treatment of folk remedies.

It is aimed at reducing fever and sore throat, immunizations and general strengthening of the body:

• Antipyretics is viburnum or raspberry tea.
• To eliminate the inflammation in the throat rinse is used infusions of chamomile, plantain, eucalyptus, sage. reduces inflammation and soda salt solution. To do this, take for 1 h. l. components of water glass. Also well it helps iodine solution (water glass nnuzhno 3 - 5 drops of iodine).
• It possesses antiviral properties Astragalus root. To prepare 250 ml of boiling water is necessary to pour into the thermos and add 1 tbsp. l. Astragalus root. Infuse for 30 - 40 min. and strain. Ready infusion drink 2 - 3 times a day for 2 tablespoons. l.
• To strengthen the immune system is effective echinacea tea. It is known for its anti-inflammatory and antimicrobial properties. tea recipe: 500 ml boiling water should take 2 hours. l. root and 3 dry powdered flower. Infuse 50 min. It can be drunk as during the illness (3 cups per day) and for the prevention of (1 cup).
• As a general tonic used tea made from lemon balm: 2 tbsp. l. Herbs (dried leaves and stems in equal amounts) Pour 250 ml of boiling water. Infuse 15 min. Daily norm of reception - 3 cups. This tea has a therapeutic effect.
  
• To reduce inflammation of lymph nodes fitoapplikatsii used. For their preparation are taken in equal amounts dried leaves of birch, black currant, mountain arnica, pine buds. Additionally, you can take the dried chamomile flowers, calendula, willow leaves. To 1 liter of boiled water should take 5 tablespoons. l. this mixture. Half an hour later drained and wet raw materials wrapped in a gauze bandage. This overlay applicator 20 min. in the lymph nodes through the day. The total number of procedures required - 9 - 10.
• For the treatment of bronchial and lung effective of calamus root infusion: for the glass to take boiled water for 1 hour. l. rhizome and infuse for half an hour. Take this infusion before meals for 1 hour. l. 5 - 7 times a day.

Features of clinical nutrition

Mononucleosis in adults, symptoms and treatment is described, followed by a metabolic disorder in an organism.

For its restoration requires a certain diet:

• Products are chosen so that 100 g protein had 100 g fat, and 400 g carbohydrates.
• To strengthen the body should eat fortified food.
• Essential vitamins of the B group, as well as vitamins A, C, D.
• Suitable for breakfast cereals, non-dairy omelette steamed. If the porridge cooked in milk, then they can not add salt and sugar.
• The lunch menu can include chicken noodle soup, buckwheat soup with vegetables, vegetable soup, cabbage soup, borscht.
• You can make a salad, seasoned with vegetable oil, which can include tomatoes, beets, apples, cucumbers, carrots.
• If mononucleosis is contraindicated sauerkraut.
• As a second course we must take dishes, steamed.

Possible complications and consequences

Complications are rare with mononukleoznoy infection. Usually they occur at sharp (visceral) form of the disease.

The system of hematopoiesis following complications can occur:

• Autoimmune hemolytic anemia, which is shown at 0.5 - 3% of patients. It starts in the first 2 weeks of illness and lasts about 1 - 2 months.
  
• Mild form of neutropenia, which takes place in a few weeks.
• Severe thrombocytopenia with the development of hemorrhagic syndrome. Extremely rare.

If mononucleosis possible neurological complications:

• acute encephalitis;
• neuritis of the facial nerve
• Hyena-Barr syndrome;
• cerebellar ataxia.

Also, the infection can cause other complications:

• In HIV-infected and AIDS patients may develop lymphomatoid granulomatosis (lung infection). This complication is more than 50% passes a lymphoma.
• Adolescents may be hallucinations and acute psychological reaction.
• In 50 - 80% of patients in the 2 - 4 weeks, there tranzimotornoe increased transaminases (hepatitis). At 5% detected jaundice.
• Possible rupture of the spleen, but only due to traumatic injury (less than 0.5% of cases). For its exclusion from the patient shows the removal of physical activity.

Adult mononucleosis disease gives symptoms are very similar to the common cold and sore throat, so they are easily confused. But for true treatment must be diagnosed promptly and correctly. Otherwise, the possible serious consequences.

Registration of the article: Lozinski Oleg

Video of mononucleosis in adults

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