Mononucleosis symptoms in infants. Mononucleosis in children: symptoms and treatment (Komarovsky). Infectious diseases. Infectious mononucleosis in children: causes

The disease infectious mononucleosis in children is called glandular fever. This is a viral disease that is characterized by a prolonged increase in temperature, sore throat, enlargement of various groups of lymph nodes, and specific changes in the peripheral blood. This disease is relevant for all age groups, but more so for young children.

Infectious mononucleosis was first described back in 1885 by Filatov, but then it was supplemented by the study of blood changes and the identification of a specific pathogen. Due to all this, this disease received its official name: infectious mononucleosis. The pathogen was later identified by two scientists - and in their honor the virus was named the Ebstein-Barr virus.

What kind of disease is mononucleosis: the causative agent of the disease

To correctly understand what kind of disease infectious mononucleosis is, and why this disease requires certain attention, you need to know some features of the virus itself.

The Epstein-Barr virus is the direct cause, that is, the infectious agent of this disease in children and adults. This representative of the herpesvirus family is prone to long-term circulation in the human body, and also has a carcinogenic effect, which can lead to irreversible consequences. It can cause the development of not only infectious mononucleosis, but also the formation of nasopharyngeal carcinoma and Burkitt's lymphoma. The Epstein-Barr Virus, like most other viruses, is transmitted by airborne droplets, through shared dishes, kisses, toys and other objects on which there is saliva from the carrier of the infection. This disease is very common.

Having entered the child’s body, the virus immediately begins to actively multiply in the mucous membrane of the nasopharynx, from where it then enters the blood and infects type B lymphocytes, which are responsible for the production of antibodies. The virus remains in these cells for the rest of its life.

There are statistics according to which by the age of 5, just over 50% of children become infected with this infection. By the age of 35, more than 90% of the population has a blood test showing the presence of antibodies to EBV. This fact gives the right to assert that the majority of the adult population has already suffered from infectious mononucleosis. In 80-85% of cases, its development occurs in an erased form, that is, its characteristic symptoms either do not appear at all or appear weakly, and the disease is mistakenly diagnosed as ARVI or tonsillitis.

Incubation period

This is the period of time from the moment the Epstein-Barr virus enters the child’s body through the throat until the first signs of the disease appear. Incubation period varies widely from several days to two months, with an average period of 30 days. At this time, the virus multiplies and accumulates in quantities sufficient for massive expansion.

A prodromal period may develop, which has no specific manifestations and is typical for all infectious diseases. In such cases, the disease will develop gradually - for several days there may be a low, subfebrile body temperature, general malaise and weakness, increased fatigue, the presence of catarrhal symptoms from the upper respiratory tract in the form of nasal congestion, redness in the mucous membranes of the oropharynx, as well as gradual enlargement and redness of the tonsils.

Symptoms of mononucleosis

From the first days, slight malaise, weakness, headaches and muscle pain, painful sensations in the joints, a slight increase in temperature and weak pronounced changes in the lymph nodes and pharynx.

The spleen and liver also enlarge. Often skin acquire a yellow tint. So-called jaundice occurs. There are no severe cases of mononucleosis. The liver remains enlarged for a long time. The organ returns to normal size only 1-2 months after infection.

A rash with mononucleosis appears on average on the 5-10th day of illness and in 80% of cases is associated with taking the antibacterial drug ampicillin. It is maculopapular in nature, its elements are bright red, located on the skin of the face, torso and limbs. The rash remains on the skin for about a week, after which it turns pale and disappears without a trace.

Mononucleosis in children is often asymptomatic or with a blurred clinical picture. The disease is dangerous for babies with congenital immunodeficiency or atopic reactions. In the first case, the virus aggravates the lack of immune defense and promotes the addition of a bacterial infection. In the second, it enhances the manifestations of diathesis, initiates the formation of autoimmune antibodies and can become a provoking factor for the development of tumors immune system.

The main signs of mononucleosis include:

the appearance of headache;
high temperature;
mononuclear tonsillitis (dirty gray films are noted on the tonsils, which can be easily removed with tweezers);
pain in muscles, joints;
weakness, sore throat, nasal congestion;
high susceptibility to other infectious agents;
frequent skin lesions with herpes;
bleeding gums;
loss of appetite;
enlarged liver and spleen;
enlargement of the lymph nodes (as a rule, the lymph nodes on the posterolateral surface of the neck enlarge, they are woven into conglomerates or chains, painless on palpation, not fused with the surrounding tissues and sometimes increase to the size of an egg).

Leukocytosis is observed in the peripheral blood (9-10o109 per liter, sometimes it can be more). The number of mononuclear elements (monocytes, lymphocytes, atypical mononuclear cells) towards the end of the 1st week reaches about 80%-90%. In the first days of the disease, obvious neutrophilia with a band shift may be observed. A mononuclear reaction (mainly due to lymphocytes) can persist from 3-6 months and even up to several years. In convalescents, after a period of infectious mononucleosis, another disease may appear, for example, acute influenza or dysentery, etc., and may also be accompanied by a quite significant increase in the number of mononuclear elements.

The disease lasts for one or more weeks. During the illness heat lasts for a week. Saving other changes occur with little dynamics. Then there is a gradual decrease in temperature. In some cases, the next wave of temperature rise occurs. As the temperature decreases, plaque in the pharynx disappears. The lymph nodes gradually become smaller. The liver and spleen generally return to normal within a few weeks or months. In the same way, the blood condition is normalized. Complications such as stomatitis, pneumonia, otitis media and others rarely occur.

Photo

What does damage to the nasopharynx look like with mononucleosis - photo

Diagnostics

At the first visit to a medical facility, the doctor conducts an examination and finds out the symptoms. If infectious mononucleosis is suspected, a blood test is taken. It is necessary not only for confirmation of this disease, but also to exclude other health problems.

If atypical mononuclear cells are detected in the blood, this confirms the diagnosis of mononucleosis. The more such cells are found in the blood, the more severe the disease will be.

Consequences

Complications are rare. The most important are paratonsillitis. In isolated cases, splenic ruptures, liver failure, acute liver failure, hemolytic anemia, acute hemolytic anemia, neuritis, . When treated with antibiotics ampicillin and amoxicillin, patients almost always experience a skin rash.

How to treat infectious mononucleosis in children

Not developed to date specific treatment infectious mononucleosis in children, there is no single treatment regimen, and there is no antiviral drug that would effectively suppress the activity of the virus. Typically, mononucleosis is treated at home, in severe cases in a hospital setting, and only bed rest, a chemically and mechanically gentle diet and a water-drinking regime are recommended.

To reduce high temperatures, children's medications such as paracetamol and ibuprofen are used. Good result mefinamic acid provides by stimulating the production of interferon. It is necessary to refrain from lowering the temperature in children with aspirin, as Reye's syndrome may develop.

The throat is treated in the same way as for a sore throat. You can use tantumverde, various aerosols, rinsing with herbal infusions, furatsilin, etc. Close attention should be paid to the oral cavity; you should brush your teeth and rinse your mouth after every meal. For severe cases, vasoconstrictor drops are used. But you should not get carried away with them for more than five days. The symptoms of the disease are eliminated, this is the supportive treatment that eliminates the infection.

If changes in liver function are detected, a special diet, choleretic drugs, and hepatoprotectors are prescribed. Immunomodulators together with have the greatest effect. Imudon, Children's Anaferon, Viferon, as well as Cycloferon at a dose of 6-10 mg/kg can be prescribed. Sometimes metronidazole (Trichopol, Flagyl) has a positive effect. Since secondary microbial flora is often associated, antibiotics are indicated, which are prescribed only in case of complications and intense inflammatory process in the oropharynx (except for penicillin antibiotics, which cause severe allergic reactions in 70% of cases in infectious mononucleosis)

A child's spleen may become enlarged during illness, and even minor injuries to the abdomen can cause it to rupture. Therefore, all children with mononucleosis should avoid contact sports and strenuous activities for 4 weeks. Athletes especially should limit their activities until the spleen returns to normal size.

In general, treatment of infectious mononucleosis in children and adults is exclusively symptomatic (drinking, lowering temperature, pain relief, facilitating nasal breathing, etc.). Prescribing antibiotics hormonal drugs is carried out only when the corresponding complications develop.

Forecast

Infectious mononucleosis in children, as a rule, has a fairly favorable prognosis. However, the main condition for the absence of consequences and complications is timely diagnosis of leukemia and regular monitoring of changes in blood composition. In addition, it is very important to monitor the condition of children until their final recovery.

Also, children who have recovered from the disease need a medical examination over the next 6-12 months to monitor residual effects in the blood. It is worth noting that activities on specific and effective prevention infectious mononucleosis does not currently exist.

Infectious mononucleosis was first described by N. Filatov at the end of the 19th century. The disease is called idiopathic lymphadenitis. This is an acute viral infection characterized by changes in lymph, enlargement of the liver and spleen, and hyperemia of the throat. The disease is caused by Epstein-Barr virus type 4, which destroys lymphoid-reticular tissue.

Infectious mononucleosis often occurs in children, especially under 10 years of age. Boys are twice as likely to be exposed to it than girls. Most people on the planet suffer from mononucleosis, but 80% of patients have mild symptoms or are asymptomatic. Symptoms are especially pronounced in weakened children with low immunity.

Causes of development and routes of infection

Children after 3-5 years of age usually stay in closed groups of a kindergarten or school, so the greatest likelihood of contracting mononucleosis is there. The virus is transmitted by airborne droplets or household contact through close contact between a carrier and a healthy person. In the environment, the pathogen dies very quickly. In a sick child, it remains in the saliva for another 6 months after recovery and can be transmitted by:

cough;
kiss;
using the same utensils and hygiene products.

Sometimes the virus is transmitted when blood contaminated by it is transfused into a healthy person. It is difficult to diagnose mononucleosis in children under 10 years of age, since it has a blurred clinical picture and passes quickly. In adolescents and adults, the course of the disease can last for months. If a child has been ill once, he or she develops lifelong immunity, but the Epstein-Barr virus remains in the body.

Characteristic signs and symptoms

Today there is no prevention against viral infection, so it is necessary to pay attention to symptoms that may indicate that a child is infected. In infectious mononucleosis they can be varied. The disease can be practically asymptomatic or have a pronounced clinical picture.

From the moment the virus enters the body until the first manifestations of the disease can pass from 1 week to several months. The child develops general weakness and malaise. As the disease progresses, the patient's well-being becomes worse. The temperature rises to low-grade levels, a sore throat and nasal congestion appear. Mononucleosis is characterized by redness of the throat mucosa and enlargement of the tonsils.

With a pronounced course of the disease, there may be a fever that lasts several days. Besides, The patient has the following symptoms:

excessive sweating;
headache;
pain when swallowing;
drowsiness;
muscle aches.

After this they increase specific symptoms infectious mononucleosis:

hyperemia of the posterior wall of the throat mucosa, its hemorrhage;
enlargement of peripheral lymph nodes;
general intoxication;
enlarged spleen and liver;
rash on the body.

Rashes may appear at the beginning of the infectious process along with fever. They look like spots of pale pink or red color, which are localized on different parts body (face, stomach, limbs, back). The rash does not require treatment. It does not cause itching and goes away gradually on its own.

A distinctive sign of mononucleosis is polyadenitis due to hyperplasia of lymphoid tissue. Grayish or yellow-white lumpy deposits form on the tonsils. They have a loose structure and can be easily removed.

The child experiences enlargement of the cervical lymph nodes (sometimes up to 3 cm). They become a barrier to the active virus. The lymph nodes in the back of the neck are especially noticeably enlarged. In most cases, lymph node involvement is bilateral. There is practically no pain on palpation. Rarely there is an enlargement of the lymph nodes in the abdominal cavity, in which the child may experience signs of an acute abdomen.

The liver and spleen are very sensitive to the Epstein-Barr virus. Therefore, changes occur in them immediately after infection of the body. Over the course of about 2-4 weeks, these organs continuously increase in size. After which they gradually return to their normal physiological position.

Diagnostics

Since the symptoms of infectious mononucleosis are very vague, it is necessary to undergo several tests to confirm the diagnosis:

general and biochemical analysis blood;
blood to determine the titer of antibodies to the Epstein-Barr virus;
Ultrasound internal organs.

Based on external signs, it is difficult for a doctor to differentiate between tonsillitis and mononucleosis. Therefore, serological studies are carried out. A complete blood count may show elevated levels of leukocytes, lymphocytes and monocytes. With mononucleosis, the blood content increases atypical mononuclear cells. But they appear only 2-3 weeks after the virus enters the body. Also, when making a diagnosis, it is necessary to exclude diseases such as diphtheria, leukemia, Botkin's disease.

Methods and rules of treatment

There is no specific treatment for infectious mononucleosis in children. The doctor prescribes only symptomatic treatment to alleviate the child’s condition. During the first 2 weeks you need to adhere to bed rest. Antibiotics are not effective for viral infections (only for secondary infections). In addition, they reduce already weakened immunity.

Drug therapy

At high temperatures, taking antipyretic drugs is indicated:

Ibuprofen;
Paracetamol;
Efferalgan.

Attention parents! In case of infectious mononucleosis, it is prohibited to use aspirin to reduce the temperature in a child to avoid the development of Reye's syndrome.

Antiseptics are used to treat the throat local remedies, as with a sore throat:

Tandum Verde;
Orasept;
Furacilin;
Chlorophyllipt.

If there are signs of rhinitis, the use of vasoconstrictor drops is indicated (no longer than 5 days):

Nazivin;
Otrivin;
Nazol.

The following agents are used as immunomodulatory therapy:

IRS 19;
Imudon;
Viferon;
Anaferon.

They are effectively used together with antiherpetic drugs (Acyclovir). Rarely, in severe cases of mononucleosis, anti-inflammatory hormonal drugs (Prednisolone) are prescribed. It is imperative to support the child’s body with a sufficient amount of vitamins.

Hepatoprotectors and choleretic agents for liver changes:

Chophytol;
Allohol;
Gepabene.

If a bacterial infection occurs, antibiotics (except penicillins) are required. At the same time, you need to take probiotics to normalize the intestinal microflora (Linex, Narine).

A child should be hospitalized if he has:

temperature above 39 o C;
severe general intoxication;
threat of asphyxia;
other complications.

Diet and nutrition

A child will recover faster from infection with the virus if he is provided with the correct drinking and eating regimen. During illness, drinking should be plentiful, at least 1.5 liters of water per day. Since infectious mononucleosis affects the functioning of the liver, nutrition should be gentle (stick to it for another ½-1 year after recovery).

The child’s diet should not contain fatty, fried, smoked foods and sweets. Exclude legumes, garlic, onions. Minimize the consumption of sour cream, butter, and cheeses.

Food should be light and rich in vitamins. The menu should include:

porridge;
dairy products;
fish;
fresh fruits and vegetables.

Prognosis and possible complications of the disease

In most cases, the prognosis for infectious mononucleosis is favorable. The main condition for eliminating complications is to monitor changes in the blood so as not to miss leukemia and other complications. The child's condition should be closely monitored until complete recovery.

Within a month, the lymph nodes return to their normal size, and the sore throat goes away in 1-2 weeks. Long time after recovery, the child remains weak, drowsy, and quickly gets tired. Therefore, it should take another ½-1 year dispensary observation, check the composition of the blood.

Complications from mononucleosis are rare. It can be:

splenic rupture (1 case in 1000);
pneumonia;
meningoencephalitis;
jaundice.

Infectious mononucleosis in children, like most viral diseases, has no specific treatment. Therefore, it is important to detect the disease in a timely manner and follow all doctor’s instructions to speed up the child’s recovery. In order for the body to quickly cope with any viral infection, it is necessary to strengthen the immune system from an early age, monitor proper nutrition and lifestyle.

Symptoms and treatment for mononucleosis in children differ from those in adults. An illness without fever, changes in the baby’s blood, vague symptoms, ineffective treatment – a shock for parents.

What kind of disease is mononucleosis? Mononucleosis is an acute infectious pathology, the contagion is the specific Epstein-Barr virus. This virus spreads from person to person through aerosol transmission. Children from one to 7 years of age get sick more often, adults less often. The disease is characterized by a cyclical course: fever, sore throat, pharyngitis, swelling of the lymph nodes, escalation of the liver and spleen, accompanied by fluctuations in the blood (increased lymphocytes and monocytes, the appearance of atypical mononuclear cells). Mononucleosis, symptoms and treatment in children has its own characteristics.

Mononucleosis is caused by the Epstein-Barr virus, which has poor viability in the external environment.

Is a domestic cat contagious with mononucleosis? You can only get infected from humans; animals do not get sick. The infection does not belong to epidemics, therefore, when it is detected - kindergarten, the school is not closing, but simply strengthening the disinfection regime in the institution.

Spread by aerosol, through unprotected sex, kissing, everyday objects, toys infected with children's saliva. Cases of transmission through blood transfusion have been reported. Weakened immunity is a predisposing factor to the disease and contributes to the generalization of infection with possible complications and transition to a chronic course.

Differences between mononucleosis in children

The signs and treatment of mononucleosis in children are somewhat different from adults: children up to one year old do not get sick due to the presence passive immunity, adults suffer from this until the age of forty, until acquired immunity is formed. Boys get sick more often, girls get sick less often.

Persons who have recovered from infectious mononucleosis develop lifelong immunity; repeated mononucleosis does not occur, but manifestations of infection may be observed due to reactivation of the virus. The main cause of the disease is the deterioration of the body’s defenses, that is, the susceptibility to other viruses and infections decreases.

Symptoms of mononucleosis in childhood

The disease exhibits a certain cyclicity. Incubation phase 4-50 days. The disease has stages: onset, peak, convalescence. Atypical mononucleosis in children shows symptoms slowly.

The start lasts a week. Acute phase:, sore throat, difficulty swallowing and swollen lymph nodes. The child is lethargic, weak, sleepy. Loss of appetite, muscle and joint pain. Signs characteristic of a peak:

fever;
swelling of the lymph nodes;
runny nose, sore throat, cough;
escalation (enlargement) of the liver and spleen;
specific changes in blood tests.

“In the vast majority of people, infectious mononucleosis passes without symptoms, that is, 85%; in 50% of children, by the age of 5, special antibodies to mononucleosis are found in the blood,” says Dr. Komarovsky.

Temperature with mononucleosis

There is no single temperature dependence in mononucleosis. At the start of the disease, the temperature is subfebrile (37.5 C), at its peak it can rise to 38.5-40.0 C and lasts for a couple of days, then slowly decreases to subfebrile levels. The peculiarity of the disease is an unexpressed intoxication syndrome. If the baby's temperature is low, he moves well, although he refuses to eat, weakness and fatigue prevail. Intoxication lasts 2-4 days.

Inflammation of the lymph nodes

Reaction of the cervical lymph nodes by: enlargement, pain, swelling - persistent symptom(polyadenopathy) accompanying mononucleosis. Epstein-Barr virus infects lymphoid tissue. Swelling of the cervical lymph nodes is most often observed. Occasionally other lymph nodes react: under the jaw, axillary, on the back of the head. Polyadenopathy occurs from 3-4 weeks to 2-3 months.

Inflammatory changes in the nose and pharynx

When you have mononucleosis, you are always worried about a sore throat, swelling of the tonsils, which occasionally connect with each other, causing apnea. Sometimes gum bleeding occurs. With swelling of the nose and nasopharyngeal tonsil, nasal congestion occurs - runny nose.

Warning about suffocation. On the tonsils (3-7 days) white, gray plaque, as with a sore throat. The lymphoid follicles in the pharynx are enlarged, swollen, reddened (pharyngitis) - coughing is bothersome. When children start coughing, only then do parents consult a doctor.

Escalation of the liver and spleen

In children, enlargement of the liver and spleen is a characteristic symptom. At the beginning of the manifestation of the disease, the liver grows in size and decreases at its apogee. The child is palpated; it is firm and painless. An enlarged spleen occurs on days 3-5 and lasts up to 1 month. These signs are accompanied by jaundice (3-7 days). At the same time, nausea, vomiting, and loss of appetite are noted.

Specifics of the blood test

During liver escalation, bilirubin and aminotransferase increase in the blood. In a clinical blood test at the onset of the disease, leukocytes are 15-30x10 to the 9th power per liter. Lymphomonocytosis (80-90%), increased band neutrophils and decreased segmented neutrophils. ESR rises to 20-30 mm per hour.

The main feature of mononucleosis is the presence of irregularly shaped monocytes (mononuclear cells) in the blood. Mononuclear cells (5-50%) are found in 95.5% of cases of infection, from 2-3 days from the moment of illness, remaining 2-3 weeks.

Differential diagnosis: polymerase chain reaction method, the appearance of a characteristic DNA virus in smears, urine, blood; ELISA method ( linked immunosorbent assay) – determine the presence or absence of certain antibodies to viruses.

Mononucleosis rash

Other symptoms of mononucleosis in children are the appearance of exanthema of a maculopapular nature on the skin, in approximately 10% of cases and 80% during treatment with penicillin antibiotics. The rash is without clear localization, does not itch and disappears quickly, leaving no marks on the body.

Atypical and visceral course

Atypical mononucleosis in a child is a phase where there are no leading signs; to confirm the diagnosis, a series of laboratory tests must be carried out.

Occasionally, they meet visceral form illnesses with severe multifaceted pathologies and, accordingly, a poor prognosis.

Chronic course

The chronic form of the disease is the consequences of mononucleosis. Characteristic:

malaise, discomfort;
increased fatigue;
insomnia, headaches, dizziness;
muscle weakness, low-grade fever;
pharyngitis, polyadenopathy, rashes all over the body.

The diagnosis is based only on accurate laboratory tests.

Convalescence period

The time of recovery (convalescence) follows after the height of the illness. General state in children it gradually improves, the temperature returns to normal, manifestations of sore throat disappear, the liver and spleen decrease. Lymph nodes return to normal, swelling disappears. The duration of convalescence is individual in each case.

Treatment

If there is no complication of mononucleosis, then it is carried out at home, but under the supervision of a family doctor.

You can eat in small quantities:

dairy products: sour cream, cheese, butter;
vegetable oils up to 50.0 grams per day;
broths;
lean meat, fish;
fruits vegetables.

For mononucleosis, there is no specific treatment; symptomatic therapy is carried out. Symptomatic treatment includes frequent gargling with antiseptics, antipyretic drugs, and immune boosters. When a child coughs up phlegm, alkaline is good mineral water. Recovery is slow. Hardening, walks fresh air, balanced nutrition will help the child recover.

Conclusion

Like any other viral disease, they manifest themselves in their own way. The usual form of the disease is based on characteristic symptoms: fever, inflammation of the lymph nodes, runny nose, sore throat, pharyngitis, enlarged liver and spleen, blood changes. There is no temperature dependence; it can be: normal, low-grade, fever. The duration and course of the disease depend entirely on the individual reactivity of the child’s immune system.

Special treatment regimens have not been developed, therefore they resort to symptomatic therapy designed to eliminate the manifestations of the symptoms of the disease and alleviate the baby’s suffering. Boosting immunity will help the child recover quickly.

Infectious mononucleosis is one of the most common viral infections on earth: according to statistics, 80-90% of adults have antibodies to the causative agent in their blood.

It is the Epstein-Barr virus, named after the virologists who discovered it in 1964. Children, adolescents and young adults are most susceptible to mononucleosis. In people over 40 years of age, it develops extremely rarely, since before this age stable immunity is formed as a result of an infection.

The virus is especially dangerous for people over 25 years of age and pregnant women (subject to primary infection), as it causes a severe course of the disease, the addition of a bacterial infection, and can cause miscarriage or stillbirth. Timely diagnosis And competent treatment significantly reduce the risk of developing such consequences.

What it is?

Infectious mononucleosis is an acute pathology of infectious genesis and anthroponotic profile, the course of which is accompanied by the appearance of a febrile reaction, damage to the oropharynx and organs of the reticuloendothelial system, as well as a provoking disturbance in the quantitative and qualitative composition of the blood.

Story

The infectious nature of this disease was pointed out by N. F. Filatov in 1887, who was the first to draw attention to a febrile disease with enlarged lymph nodes and called it idiopathic inflammation of the lymph glands. The described disease bore his name for many years - Filatov's disease. In 1889, the German scientist Emil Pfeiffer described a similar clinical picture of the disease and defined it as glandular fever affecting the pharynx and lymphatic system.

With the introduction of hematological research into practice, characteristic changes in blood composition in this disease were studied, according to which American scientists T. Sprunt and F. Evans called the disease infectious mononucleosis. In 1964, M.A. Epstein and I. Barr isolated a herpes-like virus from Burkitt's lymphoma cells, named in their honor the Epstein-Barr virus, which was later found with great consistency in infectious mononucleosis.

Pathogenesis

The Epstein-Barr virus is inhaled by a person and infects the epithelial cells of the upper respiratory tract, oropharynx (promoting the development of moderate inflammation in the mucous membrane), from there the pathogen enters the regional lymph nodes with the lymph flow, causing lymphadenitis. When the virus enters the blood, it invades B lymphocytes, where it begins active replication.

Damage to B lymphocytes leads to the formation of specific immune reactions and pathological deformation of cells. The pathogen spreads throughout the body through the bloodstream. Due to the fact that the virus invades immune cells and immune processes play a significant role in pathogenesis, the disease is classified as AIDS-associated. The Epstein-Barr virus persists in the human body for life, periodically being activated against the background of a general decrease in immunity.

Routes of transmission

Epstein-Barr virus is a ubiquitous member of the herpevirus family. Therefore, infectious mononucleosis can be found in almost all countries of the world, usually in the form of sporadic cases. Outbreaks of infection are often recorded in the autumn-spring period.

The disease can affect patients of any age, but children, adolescent girls and boys most often suffer from infectious mononucleosis. Infants get sick quite rarely. After suffering an illness, almost all groups of patients develop lasting immunity. The clinical picture of the disease depends on age, gender and the state of the immune system.

Sources of infection are virus carriers, as well as patients with typical (manifest) and latent (asymptomatic) forms of the disease. The virus is transmitted by airborne droplets or through infected saliva. In rare cases, vertical infection (from mother to fetus), infection during transfusion and during sexual intercourse is possible. There is also an assumption that EBV can be transmitted through household items and the nutritional (water-food) route.

Epidemiology

The source of infection is a sick person, including those with erased forms of the disease, and a virus carrier. The pathogen is transmitted from a sick person to a healthy person by airborne droplets, most often with saliva (for example, by kissing, hence the name “kissing disease”, by sharing utensils, linen, bed, etc.), transmission of the infection is possible through blood transfusion . Infection is facilitated by overcrowding and close quarters of patients and healthy people Therefore, outbreaks of the disease in dormitories, boarding schools, camps, and kindergartens are not uncommon.

Mononucleosis is also called “student disease”, since the clinical picture of the disease develops in adolescence and young adulthood. About 50% of the adult population become infected during adolescence. The maximum incidence in girls is observed at the age of 14–16 years, in boys - at 16–18 years. By the age of 25–35, most people have antibodies to the infectious mononucleosis virus in their blood. However, in HIV-infected people, viral reactivation can occur at any age.

Symptoms of mononucleosis in a child

The symptoms of infectious mononucleosis are varied. Sometimes general signs of a prodormal nature appear, such as weakness, malaise and catarrhal symptoms. Gradually, the temperature rises to low-grade fever, health worsens, a sore throat is observed, and nasal congestion worsens breathing. Symptoms of the development of mononucleosis also include pathological growth amygdalin and hyperemia of the mucous membrane of the oropharynx.

Sometimes the disease begins suddenly and has pronounced symptoms. In this case it is possible:

increased sweating, chills, drowsiness, weakness;
fever, it occurs in different ways (usually 38 -39C) and lasts several days or even a month;
signs of intoxication - headache, muscle aches and painful sensations when swallowing.

At the culmination of the disease, the main features of infectious mononucleosis appear, such as:

sore throat - on back wall the mucous membrane of the pharynx develops granularity, follicular hyperplasia, hyperesia, and possible hemorrhage in the mucous membrane;
lymphadenopathy - an increase in the size of the lymph nodes;
lepatosplenomegaly – enlargement of the spleen and liver;
skin rash all over the body;
general intoxication of the body.

Most important symptom infectious mononucleosis is traditionally considered polyadenitis. It occurs as a result of hyperplasia of lymphoid tissue. In most cases, islands of a gray or whitish-yellowish hue develop on the tonsils of the nasopharynx and palate. Their consistency is loose and lumpy, they are easily removed.

The rash in mononucleosis most often occurs at the onset of the disease, simultaneously with fever and lymphadenopathy, and it can be quite intense, localized on the legs, arms, face, abdomen and back in the form of small red or pale pink spots. The rash does not require treatment, since it does not itch, cannot be smeared with anything, and will disappear on its own as the immune system strengthens its fight against the virus. However, if a child is prescribed an antibiotic and the rash begins to itch, this indicates an allergic reaction to the antibiotic (most often this is penicillin series antibiotics - ampicillin, amoxicillin), since the rash with mononucleosis does not itch.

Infectious mononucleosis is characterized by hepatosplenomegaly, that is, pathological enlargement of the spleen and liver. These organs are very sensitive to the disease, so changes in them begin to occur in the first days after infection. The spleen may become so enlarged that its tissues cannot withstand the pressure and it ruptures. In addition, peripheral lymph nodes enlarge. The actively reproducing virus is retained in them. Lymph nodes grow especially intensively on back surface necks: they become very noticeable when the child turns his head to the sides. Nearby lymph nodes are interconnected, and almost always their damage is bilateral.

During the first 2-4 weeks, there is a continuous increase in the size of these organs, and to some extent it continues after the child’s recovery. When body temperature returns to physiological values, the condition of the spleen and liver is normalized.

What diseases can infectious mononucleosis be confused with?

Infectious mononucleosis should be differentiated from:

ARVI of adenoviral etiology with severe mononuclear syndrome;
diphtheria of the oropharynx;
viral hepatitis (icteric form);
acute leukemia.

It should be noted that the greatest difficulties arise when differential diagnosis infectious mononucleosis and acute respiratory viral infection of adenoviral etiology, characterized by the presence of pronounced mononuclear syndrome. In this situation, distinctive signs include conjunctivitis, runny nose, cough and wheezing in the lungs, which are not characteristic of glandular fever. The liver and spleen also rarely enlarge during ARVI, and atypical mononuclear cells can be detected in small quantities (up to 5-10%) once.

In this situation, the final diagnosis is made only after serological tests.

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Diagnosis of the disease

To confirm mononucleosis, the following studies are usually prescribed:

blood test for the presence of antibodies to the Epstein-Barr virus;
biochemical and general tests blood;
Ultrasound of internal organs, primarily the liver and spleen.

The main symptoms of the disease on the basis of which the diagnosis is made are enlarged lymph nodes, tonsillitis, hepatosplenomegaly, and fever. Hematological changes are a secondary sign of the disease. The blood picture is characterized increase in ESR, the appearance of atypical mononuclear cells and wide-plasma lymphocytes. However, it should be borne in mind that these cells can appear in the blood only 3 weeks after infection.

When carrying out differential diagnosis, it is necessary to exclude acute leukemia, Botkin's disease, tonsillitis, diphtheria of the pharynx and lymphogranulomatosis, which may have similar symptoms.

Chronic mononucleosis

Prolonged persistence of the virus in the body is rarely asymptomatic. Considering that with a latent viral infection, a wide variety of diseases can appear, it is necessary to clearly identify the criteria for diagnosing chronic viral mononucleosis.

Symptoms of the chronic form:

a severe form of primary infectious mononucleosis suffered within six months or associated with high titers of antibodies to the Epstein-Barr virus;
an increase in the content of virus particles in the affected tissues, confirmed by anti-complementary immunofluorescence with the pathogen antigen;
damage to some organs confirmed by histological studies (splenomegaly, interstitial pneumonia, uveitis, bone marrow hypoplasia, persistent hepatitis, lymphadenopathy).

Complications

Complications of infectious mononucleosis are mainly associated with the development of an associated secondary infection (staphylococcal and streptococcal lesions). Meningoencephalitis and obstruction of the upper respiratory tract by hypertrophied tonsils may occur.

Children may experience severe hepatitis, and sometimes (rarely) interstitial bilateral infiltration of the lungs develops. Rare complications also include thrombocytopenia; overstretching of the lienal capsule can provoke rupture of the spleen.

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How to treat infectious mononucleosis

Treatment of most typical cases of infectious mononucleosis is carried out under conditions infectious diseases department. In mild cases, treatment can be carried out on an outpatient basis, but under the supervision of a local doctor and an infectious disease specialist.

During the height of the pathology, the child must comply with bed rest, a chemically and mechanically gentle diet and water and drinking regime.

Symptomatic therapy includes antipyretic drugs, local antiseptics for the throat (Hexoral, Tandum Verde, Strepsils, Bioparox), analgesics, rinsing the mouth with herbal decoctions, furatsilin. Etiotropic treatment (the action is aimed at destroying the pathogen) has not been definitively determined. It is recommended to use in children antiviral drugs based on interferon (Viferon suppositories), immunomodulatory agents (isoprinosine, arbidol).

In small or weakened children, the prescription is justified antibacterial drugs With wide range actions, especially if there are purulent complications(pneumonia, otitis, meningitis). When the central nervous system is involved in the process, symptoms of asphyxia, decreased bone marrow function (thrombocytopenia), it is used hormone therapy within 3-5 days.

Rehabilitation

Clinical observation for 6 months or more with the participation of a pediatrician, infectious disease specialist, specialists in narrow fields (ENT, cardiologist, immunologist, hematologist, oncologist), with the use of additional clinical and laboratory studies (given in the diagnostics section + EEG, ECG, MRI, etc.) d).

Also exemption from physical culture, fencing from emotional stress– compliance with the protective regime for about 6-7 months. You should always remain on guard, as any compromise can trigger autoimmune reactions.

Prevention

In most situations, infectious mononucleosis proceeds favorably, and yet, like any other infection, this pathology leaves the development of severe consequences such as meningoencephalitis, obstructive diseases of the respiratory tract, as well as pathological enlargement of the tonsils.

Rare consequences of infectious mononucleosis are the development of bilateral interstitial infiltration of the lungs, toxic hepatitis, thrombocytopenia and splenic rupture, which can be avoided by following basic preventive nonspecific measures.

Due to the fact that specific prevention of such a disease as infectious mononucleosis is not carried out, special attention should be paid to measures of non-specific significance to prevent it. The most effective measures for the prevention of infectious mononucleosis are those that ensure the formation normal operation human immune system, which is possible by maintaining a healthy lifestyle, rationalization eating behavior people of different ages, using a variety of hardening techniques and periodic use of immunomodulators of plant origin. As such medications, you should use a course of Immunal, Immunorm, which, in addition to stimulating immune reactions, activate the regeneration of mucous membranes, providing complete protection of the respiratory system.

Nonspecific prevention of infectious mononucleosis in children involves minimizing possible close oral contact with other people and carrying out an adequate scheme of sanitary and hygienic measures.

Forecast

Most patients have a favorable prognosis. The disease occurs in mild and erased forms and is easily treated symptomatic treatment. Problems occur in patients with low immunity, in which the virus begins to actively multiply, which leads to the spread of infection.

There are no preventive measures against infectious mononucleosis, with the exception of a general strengthening of the body's immune system with the help of balanced nutrition, hardening and physical activity. In addition, you should avoid crowded places, ventilate the room and isolate such patients, especially from children.

Content

Weakness, sore throat, fever are signs reminiscent of flu or sore throat. Mononucleosis in children is a viral disease that occurs in an acute form and is characterized by an enlargement of the spleen, liver, and lymph nodes throughout the body (lymphadenopathy). A characteristic feature The disease is caused by a change in blood composition. For what reasons does the disease develop, how is it treated? Parents should know the symptoms of the disease and its consequences in order to consult a doctor in time.

Pathogen

Infectious mononucleosis in children is caused by the Epstein-Barr virus (herpes type 4), which belongs to the genus Limphocryptovirus, subfamily Gammaherpesvirinae, family Herpesviridae. The action of the infectious agent is aimed at damaging the body's lymphatic system. The virus has the following features:

captures lymphocytes - cells of the immune system that resist infection;
penetrates their DNA, changes genetic information, disrupts functions;
does not cause the death of lymphocytes, but stimulates cell growth, unlike other herpes viruses.

The infectious agent quickly dies in the external environment from drying out, the action of disinfectants (antimicrobial drugs), and high temperatures. The Epstein-Barr virus is dangerous for humans because it has the following properties:

remains in the body;
within 18 months after infection, it is released into the external environment from the oropharynx;
disrupts liver function;
damages the pharyngeal and palatine tonsils;
increases the risk of developing cancer pathologies.

How is it transmitted?

Viral mononucleosis in children is transmitted in several ways. The source of infection is a patient or a virus carrier (a person who has been ill and recovered). Children and teenagers get sick more often. Infection often occurs where sick and healthy people come into close contact - in schools, kindergartens, and dormitories. There are several ways of infection:

Intrauterine. The fetus becomes infected through the general bloodstream from a sick mother during pregnancy.
Airborne. Physiological fluids - mucus, saliva get to a healthy child from a sick child when coughing or sneezing.

Most people who have had an infection in childhood or adolescence develop antibodies to the virus. In this case, a person remains a carrier of the pathogen for the rest of his life and can transmit it during a blood transfusion, during an organ or bone marrow transplant operation. Doctors distinguish the contact-household method infectious infection. The virus is transmitted through saliva through kissing. The causative agent of mononucleosis comes from a sick child as a result of using:

shared toys in kindergarten;
someone else's bed linen, clothes;
shared dishes, towels;
someone else's nipples.

Forms

Doctors distinguish several types of mononucleosis. They differ in the course of the disease and symptoms. The following forms of infection cannot be ruled out:

Typical – characterized by fever, sore throat, enlarged spleen and liver. Blood tests indicate the presence of mononuclear cells (a type of white blood cell) and heterophilic antibodies.
Atypical form. Its symptoms are smoothed out or have a strong severity. The child may develop a high temperature, and damage to the nervous system, heart, kidneys, and lungs may begin. The infection has a tendency to develop complications.

Often the disease occurs in an acute form with bright severe symptoms. In the absence of treatment, the presence of a large number of viruses in the body, the infection progresses to chronic stage. Depending on the symptoms, the degree of enlargement of the lymph nodes, spleen, liver, the amount of mononuclear cells in the blood, the stage of the disease is divided into severe, moderate and mild. According to the nature of the course of mononucleosis in children, the following forms are distinguished:

smooth;
uncomplicated;
complicated;
protracted

Symptoms in children

If the baby strong immunity, the infectious agent, having entered the body, can live in it asymptomatically for a long time.The incubation period lasts 21 days, but with weakened protection, the infection develops after 5 days. The symptoms of mononucleosis are similar to other diseases; pediatricians must differentiate them from the following pathologies:

lymphogranulomatosis;
viral hepatitis;
rubella;
acute leukemia;
diphtheria;
angina;

The very first symptom of the development of an infectious disease is enlarged lymph nodes. The cervical, occipital, and submandibular peripheral organs are most affected; inflammation is accompanied by severe pain. As the infection develops, the inguinal, abdominal, axillary lymph nodes. Then inflammation of the tonsils and swelling of the tissues in the nose appear. The following signs of mononucleosis in children are observed:

sore throat when swallowing;
white plaque on the tonsils;
bad breath;
difficulty in nasal breathing;
night snoring;
runny nose;
cough.

When infected with the Epstein-Barr virus, the body becomes intoxicated with waste products. At the same time, the temperature rises to 39 degrees, fever, chills, aches in the bones and muscles are observed. Symptoms of mononucleosis include:

pink rash all over the body, without itching, which goes away on its own;
enlarged spleen, liver;
darkening of urine;
headache;
high fatigue;
refusal to eat;
weakness;
lethargy.

Infection increases sensitivity to the development of respiratory pathologies. There is a disturbance in the functioning of the heart - murmurs, rapid heartbeat. The disease is accompanied by the following symptoms:

development of sore throat, bronchitis;
changes in blood counts;
damage to the lips by the herpes simplex virus;
swelling of the eyelids, face;
dizziness;
migraine;
insomnia;
fatigue syndrome.

Chronic mononucleosis

The danger is posed by late diagnosis of infection and lack of timely treatment. The disease becomes chronic. The temperature during mononucleosis in children in this case remains normal, the following symptoms are present:

constant enlargement of lymph nodes;
fast fatiguability;
drowsiness;
decreased activity;
bowel dysfunction - constipation, diarrhea;
stomach ache;
nausea;
weakness;
vomit.

Symptoms when chronic form infections are often similar to acute infections, but are less severe. Enlargement of the spleen and liver occurs rarely. The disease is dangerous due to the development of the following complications in a child:

hemophagocytic syndrome - destruction of the body's own blood cells;
damage to nerve centers, brain;
changes in heart function;
blood clotting problems;
violation of facial expressions;
development of migraine;
psychoses;
anemia.

Spicy

More often, the infection occurs in an acute form, which lasts up to two months. Lymphadenopathy develops - damage to the lymph nodes, accompanied by an increase in size and pain. Swelling of the mucous membranes of the oral cavity provokes breathing problems and throat hyperemia. The child complains of the appearance of:

general weakness;
sore throat, especially when swallowing;
nasal congestion;
runny nose;
severe chills;
lack of appetite.

For acute form Mononucleosis is characterized by fever, nausea, aches in the muscles, joints, and fever. When children develop an infection, they may:

hepatomegaly – enlarged liver;
small rash on the chest, back, face, neck;
white plaque on the tonsils, palate, tongue, back of the throat;
splenomegaly - an increase in the size of the spleen;
photophobia;
swelling of the eyelids

Play a major role in the differential diagnosis of infectious mononucleosis laboratory research. Based on their results, pediatricians prescribe treatment. Blood tests are performed:

General – determines ESR (erythrocyte sedimentation rate), the content of monocytes, leukocytes, lymphocytes. When sick, their number increases 1.5 times. Mononuclear cells appear in the blood only a few days after infection. The more there are, the more severe the disease.
Biochemical - reveals the content of urea, protein, glucose, characterizing the condition of the kidneys and liver.

The presence of a large number of mononuclear cells in the child’s blood confirms the infection. Considering that this situation is possible in other pathologies, for example, in the case of HIV, doctors prescribe additional studies. Executed:

ELISA – enzyme-linked immunosorbent assay for antibodies to the Epstein-Barr virus;
PCR – polymerase chain reaction– high-precision, quick method DNA diagnostics of the infectious agent;
Ultrasound of the liver and spleen for changes.

Treatment

When mononucleosis is diagnosed, the child is prescribed treatment at home with bed rest. If high temperature, fever, and signs of intoxication are observed during infection, hospitalization is performed. Indications for it are:

damage to the respiratory tract, causing asphyxia (suffocation);
disruption of internal organs;
development of complications;
repeated vomiting.

Uncomplicated mononucleosis in a child does not require special treatment. Pediatricians only recommend drinking plenty of fluids. At acute stage infection you need:

humidify the air in the room where the child is;
avoid hypothermia;
provide warm drinks;
regularly carry out wet cleaning;
use medications for treatment.

The treatment regimen for the disease is aimed at relieving the symptoms of the pathology and strengthening the immune system. Treatment of infectious mononucleosis in children solves several problems:

reduction of hyperthermia (overheating of the body at high temperatures);
reducing inflammation in the nasopharynx with antiseptic agents;
activation of the immune system using immunomodulators, immunostimulants;
increasing the body's resistance with the help of vitamin complexes;
restoration of spleen and liver function choleretic agents, hepatoprotectors.

When treating an infection, much attention is paid to reducing allergic reactions on pathogens, toxins. The treatment regimen includes the use of:

antibiotics in case of secondary infection;
glucocorticosteroids for complicated hypertoxic disease, risk of asphyxia;
probiotics to restore intestinal microflora after antibiotic therapy;
artificial lung ventilation;
surgical intervention: splenectomy (removal of the spleen in case of rupture), tracheotomy (opening of the trachea) in case of laryngeal edema.

Drug treatment

The use of medications is aimed at weakening and eliminating the symptoms of an infectious lesion. Doctors use several groups medications to combat mononucleosis in children. For treatment the following is prescribed:

Antipyretic drugs – Ibuprofen, Paracetamol. Aspirin is not recommended due to the risk of acute liver failure.
Antiseptic Furacilin for gargling an inflamed throat.
Antihistamines - Claritin, Zyrtec to eliminate allergic reactions, bronchospasm, symptoms of intoxication.

Antibiotics for mononucleosis in children are used only when a secondary bacterial infection develops. The drugs Clatrimycin, Azithromycin, Metronidazole are used with the simultaneous administration of probiotics Acipol, Linex to prevent disturbances of the intestinal microflora. The following medications are used to treat infectious diseases:

hepatoprotectors – Essentiale, Galstena;
choleretic – Allohol, Karsil;
immunomodulators – Viferon, Imudon;
glucocorticosteroids - Prednisolone - if there is a threat of asphyxia in case of laryngeal edema.

To treat the infection, homeopathic Galsten drops are used. The drug contains plant components: greater celandine, dandelion, milk thistle. Characteristics of the drug:

action – hepatoprotective, choleretic, anti-inflammatory, antispasmodic;
indications – liver pathologies in acute, chronic form;
dosage – 5 drops, 3 times a day;
contraindications – sensitivity to components;
side effects - increased salivation.

Viferon is used in the form rectal suppositories. The drug has active substance– human interferon. Characteristics of the medicine:

indications – infectious viral diseases complicated by the bacterial activity of microorganisms;
dosage - set by the pediatrician depending on the severity of the pathology;
contraindications – hypersensitivity to components;
side effects - rarely skin rashes, itching.

Diet

To quickly restore health during mononucleosis, it is important to organize nutrition in such a way as to strengthen the immune system, eliminate unpleasant symptoms, and speed up recovery. There are dietary rules for treating infection:

daily calorie content of food is 1.5 times higher than normal - the body spends energy fighting the disease;
The presence of animal and plant proteins is mandatory - the basis for cells that provide immunity.

Since the disease is accompanied by a sore throat and problems with swallowing, doctors recommend preparing liquid soups, viscous porridges, and purees for mononucleosis in children. Required for dietary nutrition are:

obtaining vitamins, microelements, antioxidants from fresh vegetables, berries, fruits;
eating whole grains to provide energy to the body.

During infection, it is important to maintain a drinking regime - drink a large number of water, fruit drinks, compotes, rosehip decoction to remove toxins. The child’s diet requires the presence of:

rice, wheat, oatmeal, buckwheat porridge;
dried rye bread;
low-fat dairy products - cottage cheese, sour cream, hard cheese;
vegetable oil, butter;
poultry, rabbit, veal;
fish - cod, hake, pike perch, pike;
durum pasta;
greens - lettuce, parsley, dill;
vegetables and fruits rich in fiber;
berries;
eggs - one per day;
jam;
honey

In case of mononucleosis, limit consumption fatty foods, smoking, pickling, so as not to overload the liver. Sweets, sour and spicy foods are prohibited. Exclude from the diet:

fatty meat - duck, lamb, beef, pork;
confectionery products;
sparkling water;
concentrated meat broths;
dairy products with a high percentage of fat;
hot spices;
fatty fish;
fast food;
canned food;
chocolate;
mayonnaise;
ketchup;
mushrooms;
legumes;
garlic.

Folk remedies

Recipes using herbal ingredients are part of the treatment regimen for mononucleosis, but do not replace it. The use of any folk remedies must be agreed with a doctor to exclude complications and allergic reactions in children. The main goal of treatment is to eliminate the symptoms of the disease. To maintain immunity, it is recommended to drink healing teas with honey three times a day. To prepare them, add dry herbs (in spoons) to half a liter of boiling water:

infusion of birch, currants, lingonberries - one at a time, aged for 30 minutes;
Echinacea decoction – 3;
lemon balm tea – 2.

eliminate fever - tea made from mint, chamomile, raspberry leaves with honey, lemon juice;
counteract the symptoms of intoxication of the body - headache, body aches, nausea - linden blossom decoction, lingonberry juice;
to alleviate the condition of illness - tea from the collection of oregano, motherwort, mint, rose hips.

To reduce inflammation of the lymph nodes, it is useful to make a compress with an infusion of medicinal plants. A napkin soaked in the composition is applied every other day for 20 minutes to the area of the nodes. To prepare the infusion, pour 5 tablespoons of the mixture into a liter of boiling water and leave for half an hour. The collection includes equal parts:

currant, willow, birch leaves;
chamomile flowers, calendula;
pine buds.

Consequences

Complications after contracting mononucleosis occur in rare cases. Their cause is a weakened immune system, in which pathogenic microflora are activated and staphylococcal and streptococcal infections develop. The child may experience:

pneumonia;
sinusitis;
follicular tonsillitis;
meningoencephalitis (inflammation of the substance, membranes of the brain);
sinusitis;
paratonsillitis;
bronchial obstruction;
asphyxia (suffocation, oxygen starvation);
myocarditis (damage to the heart muscle);
neuritis (inflammation of peripheral nerves);
otitis media of the middle ear.

Since viral mononucleosis in children is accompanied by damage to the liver and spleen, the consequences of infection are associated with these organs. Development is possible:

hemolytic anemia;
acute liver failure;
rupture of the spleen as a result of excessive stretching of the organ capsule - urgent surgical intervention is required;
hepatitis A.

Relapse of mononucleosis in a child

After an infection, the body has a strong immunity to mononucleosis throughout its life. Unfortunately, in medical practice there are cases of recurrent infection in a child. These include situations related to sharp decline body defenses:

AIDS disease, which destroys lymphatic system, immunodeficiency develops;
chemotherapy administered to patients with cancer pathologies;
taking immunosuppressants in preparation for transplantation of tissues and organs to prevent their rejection.

Prevention

To avoid complications after mononucleosis, it is important to avoid contact with sick people. Increased monitoring of the child’s health is required for a year after treatment. Doctors conduct periodic blood tests. In addition, to prevent the development inflammatory processes the condition of the organs is checked:

respiratory systems;
liver;
spleen.

Prevention of mononucleosis involves measures aimed at maintaining and strengthening the immune system. Attention is paid to maintaining a balance of educational, physical activity and rest. Among the preventive measures:

healthy, long sleep;
maintaining personal hygiene;
high physical activity with regular loads;
frequent exposure to fresh air;
healthy, proper nutrition, rich in protein, slow carbohydrates, fiber;
exclusion of psychological, physical, mental overload.

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