Infectious mononucleosis is an acute viral disease characterized by increased body temperature, sore throat and enlarged lymph nodes. Also, certain changes in blood tests are characteristic.
The disease is caused by the human herpesvirus type IV, it is also called the Epstein-Barr virus - by the surnames of scientists who discovered it. Infectious mononucleosis is also called a "kiss disease", since transmission of the virus in young people can occur with saliva, during a kiss.
Infection with the Epstein-Barr virus is quite high, and in all age categories, but the virus itself is not very contagious, long-term contact with the carrier is required for infection. In young children, the disease, as a rule, proceeds easily and imperceptibly, the clinical picture of infectious mononucleosis develops in adolescence and at a young age. Adult people in the overwhelming majority are already infected with this virus.
After the primary invasion of the cells lining the nasal cavity, the virus penetrates the nasopharyngeal mucosa, and then spreads to the B-lymphocytes. In these cells, it actively multiplies, which causes the appearance of a characteristic symptomatology.
The incubation period averages from 30 to 50 days (fluctuations from 4 days to 2 months are possible). The main symptom is four:
Usually the disease begins with a feeling of general malaise, which can last up to a week, then the body temperature rises to 38-39 ° C. There is an increase in lymph nodes up to 2-3 centimeters. The liver is always involved in the process, which can be manifested by a feeling of heaviness in the right hypochondrium, as well as darkening of the urine. In addition, the spleen is affected, which at the same time increases in size.
If the patient received an antibiotic ampicillin, a skin rash is almost always observed. Other complications include encephalitis, seizures, various nervous system disorders, meningitis, and behavioral disorders. Possible, but, fortunately, a rare complication is the rupture of the spleen. This condition requires urgent surgical intervention!
The disease lasts one to two weeks, then a gradual recovery begins. Lymph node enlargement and general weakness can persist for three weeks.
The doctor makes the diagnosis taking into account the characteristics of the clinical picture, but it is not strictly specific. So, for example, a similar symptomatology is observed in cytomegalovirus infection. Infectious mononucleosis can mimic the side effects of taking certain medications, as well as some infectious diseases.
The diagnosis is based on the definition of antibodies to the virus Epstein-Barr virus. In addition, instead of affected B-lymphocytes, the body produces new, having a very characteristic form (mononuclears). Their detection during microscopy of the blood smear also speaks for infectious mononucleosis. In addition, to exclude streptococcal angina and other bacterial infections, seeding of the detachable tonsils is done.
Most patients with infectious mononucleosis recover completely. In rare cases (less than 1%), lethal outcome is possible due to the development of severe complications. Recovering is recommended full rest until the temperature normalizes and the pain in the throat disappears. To exclude the rupture of the spleen for 6-8 days, it is forbidden to lift weights and exercise even in cases when there was no detectable increase in the spleen.
Paracetamol is used to reduce body temperature with infectious mononucleosis. Aspirin is not recommended for use because of the possibility of developing Ray's syndrome.
Postponed disease leaves behind a persistent immunity.