Infectious mononucleosis and its treatment

Infectious mononucleosis /glandular fever/ is an acute contagious disease that is caused by a representative of the family of human herpesvirus – i.e. Epstein – Barr virus.

This infection is very widespread throughout the world. In developing countries and people living in poor hygienic conditions, this infection occurs in early childhood. In these cases the disease is mild or asymptomatic.

A typical form of infectious mononucleosis is more common in developed countries. In this case the infection occurs later – in school and adolescence. Clinical manifestations, however, happens in about half of infected youths.

Infection with mononucleosis

The infection with mononucleosis happens from person to person and mostly during the acute stage of the disease, but can sometimes happen in the subsequent stage after the disappearance of clinical symptoms. In some cases, the virus can persist for about a year in the saliva of the diseased person and without symptoms, but in close contact transmits it to all the people around him. Except through saliva, the virus is transmitted through contaminated hands, food, household items /toys, handkerchiefs, cutlery/ when making food, from mouth to mouth, when drinking water from the same glass, etc.

It is possible for a person to be infected, when transfused blood from a sick person. Infectious mononucleosis is called “infection kiss” because it is typical for young people in puberty.

Incubation period and symptoms

The incubation period of infectious mononucleosis is about 40 days, and the susceptibility of people is complete. Typical clinical manifestations that are frequently observed in older children and adolescents are: fever, malaise, headache and fatigue, tonsillitis and pharyngitis, swollen lymph nodes /rear-especially cervical/, increase in spleen. Characteristic changes in blood counts: highly increased number of monocytes and lymphocytes and presence of atypical cells. Serum demonstrated high titers of antibodies against Epshtayn- Barr virus. Most patients have elevated liver enzymes are often seen jaundice.

Diagnosis

The diagnosis of infectious mononucleosis is placed based on typical symptoms and laboratory tests. The disease lasts several weeks, after which there is complete recovery and development of immunity for life. In a very small percentage of older patients recovery is slower, but can occur and recurrence of infection. For younger children almost always infectious mononucleosis is going well and complications are rare. Higher risk of getting sick from infectious mononucleosis has in people with immunodeficiency diseases in which infection in the acute phase can occur very severe, and it can lead to serious complications with consequences.

Treatment of infectious mononucleosis

Complications can affect the heart, kidneys, nervous system and blood. In a small percentage of patients may occur rupture of the spleen, which is manifested by abdominal pain, pain aimed at the left shoulder and symptoms of acute blood loss.

Treatment of infectious mononucleosis is not specific. Applies only symptomatic treatment – aspirin, paracetamol and other anti-inflammatory drugs.

You should know that aspirin should not be given to children under 16 years of age and paracetamol should be given sparingly because it can affect the liver in this disease. The temperature should not be treated if below 38.5 degrees celsius and the sick should drink plenty of fluids. Infectious mononucleosis is a viral disease and should not be treated with antibiotics.

Prognosis and possible complications

Due to the fact that infectious mononucleosis affects the spleen, for the time of illness the sick should be resting in bed. Must limit physical exercise and sport at least for one month. In this period, the child should not lift any heavy objects.

During the illness the usual hygiene measures that include regular washing of the hands of the patient and those who serve it, must be followed strictly. Use individual cutlery, glasses of water, toiletries, towels and more.

Despite the fact that infectious mononucleosis is relatively severe infectious disease, we could say that it is with a good prognosis. Still you need to know and possible complications, which occur very rarely in children and young people with very weak immune system:

• secondary bacterial infection in the throat
• pneumonia
• meningitis and encephalitis
• liver injury
• damage to the spleen
• bleeding
• suppressing the formation of blood cells