Infectious mononucleosis – symptoms, treatment, complications. Mononucleosis in children

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Mononucleosis is called the kissing disease, and it has symptoms similar to the flu. It’s an infectious disease. The pathogen of infectious mononucleosis is Epstein-Barr virus from the group of herpes viruses. Other viruses and the protozoan Toxoplasma gondii can also cause mononucleosis-like syndrome. Children and adolescents are the most vulnerable to infection, and the virus that attacks once stays in the body for life.

Infectious mononucleosis – how does the disease develop?

Mononucleosis (angina monocytowa or glandular fever) is quite a popular infectious disease caused by wirus Epsteina-Barr (EBV)from the group of herpes viruses. Infection usually occurs as a result of contact with the patient’s saliva, so it most often affects young children who put their toys in their mouths, and adolescents when the time of the first kisses begins, hence the name mononucleosis – kissing disease.

Mononucleosis develops slowly – the incubation time for the virus is 30 to 50 days. After infection, the EBV virus remains in the human body, but in a latent form. It is very common, especially in adults (in 96–99% of the population), the presence of antibodies indicating contact with the disease is found. People who develop mononucleosis become completely immune to the disease.

As for alone course of mononucleosis, the first warning symptoms are usually a few days of malaise, muscle and joint pain, chills or loss of appetite. The next phase is the development of proper mononucleosis with its characteristic symptoms – the disease in this form lasts up to two or three weeks.

If you suspect mononucleosis infection, you need to see a general practitioner who will help you diagnose the disease and refer you to appropriate diagnostic tests.

See also: What does thick saliva show?

Who is at risk of getting mononucleosis?

Infection with EBV can affect anyone who comes into contact with this pathogen. This primarily means contact with the source of the infection resulting in infection. While mononucleosis is known as kissing disease, it does exist several routes of EBV infection:

1. through saliva (most often);
2. sexual way;
3. blood-borne route;
4. organ transplants.

Contact with the Epstein-Barr virus alone does not mean that a person will develop infectious mononucleosis. The most common cases of disease are:

1. in children after 4 years of age;
2. in adolescents;
3. in young adults;
4. less often in adults over 40 and infants.

What other diseases can the Epstein-Barr virus cause?

Other skin symptoms of EBV infection include:

1. Gianotti-Crosti syndrome;
2. Erythema multiforme;
3. Erythema nodosum;
4. Hives, including hives caused by cold;
5. Urticarial vasculitis;
6. Acrocyanosis;
7. Annular erythema;
8. Lichenoid dandruff;
9. Genital ulcer;
10. Linear IgA pęcherzowa dermatosis (LABD);
11. Oral hairy leukoplakia;
12. Drug-induced hypersensitivity syndrome.

Other diseases related to EBV include:

1. Burkitt lymphoma;
2. Non-Hodgkin lymphoma;
3. Hodgkin’s lymphoma;
4. Nasopharyngeal cancer;
5. Angiocentric lymphoma.

Mononucleosis – symptoms

After getting into the body, the mononucleosis virus penetrates into the salivary glands and begins to multiply there. The first symptoms of mononucleosis appear 30–50 days after infection and may be misleading. In young children, the symptoms of mononucleosis are similar to the common coldaccompanied by runny nose, muscle and back pain, sometimes mild tonsillitis. The spleen and liver can also be enlarged – this symptom is most often found in children.

With pharyngitis and tonsil involvement, whitish and yellowish patches are observed, as well as difficulty swallowing or speaking. Typical for mononucleosis is fever, which can reach 40 degrees C. The disease is also accompanied by enlarged lymph nodes in the neck, under the jaw and armpits – they are painful and moveable. In the case of an average of 5 percent. Patients have a rash that appears mainly on the trunk and resembles rubella or measles. If a patient with mononucleosis takes a penicillin antibiotic, the likelihood of a rash rises to 70 percent.

Older patients are more prone to jaundice, and lab tests will show high bilirubin levels and liver enzymes, and white blood cell counts will not be as high or will show as many lymphocytes as younger people.

With mononucleosis, swelling may sometimes appear on the eyelids, bridge of the nose or browbones. If the virus attacks the liver, there are still symptoms of inflammation of the heart muscle and tissues surrounding the heart, and an attack in the bone marrow or central nervous system (brain and spinal cord). Less common symptoms of mononucleosis include chest pain, coughing, shortness of breath, high heart rate, hives, stiff neck, epistaxis, and sensitivity to light. The testicles may also become swollen or inflamed.

You don’t know if you have angina or mononucleosis? Don’t ignore any symptoms and consult a doctor as soon as possible. Use the online visit option and receive advice and e-prescription without leaving your home even in 5 minutes.

Check it out: Purulent (streptococcal) angina – causes, symptoms and treatment

Mononucleosis in children

Younger children tend to have much milder symptoms of mononucleosis compared to teens and young adults. The infant may have no symptoms or mild symptoms.

Symptoms of infectious mononucleosis in children are similar to the flu. First, the toddler refuses to eat for a few days, lacks appetite, complains of fatigue, back pain and leg pain. Over time, you get a sore throat and a high temperature. Cervical lymph nodes also grow. These types of symptoms are usually considered a common viral infection and are often underestimated, making it more difficult for children to diagnose mononucleosis. For one hundred percent diagnostic certainty, special blood tests are performed. The infectious mononucleosis virus attacks lymphocytes (white blood cells) and causes their characteristic image.

It is not possible for every child with flu-like symptoms to be screened for mononucleosis. Sometimes doctors diagnose mononucleosis in children quite randomly, and some, believing it to be a common throat infection, prescribe an antibiotic for the child. Only when the rash occurs does a red light come on, suggesting it is more than a simple viral infection.

In order to avoid infections or colds, it is worth enriching your daily diet with natural dietary supplements that strengthen the immune system. Whole Immuno is a good choice. The product is a source of zinc and vitamin C, thanks to which it supports the immune system and prevents the development of infections.

See: Diseases that cause a decrease in immunity

Mononucleosis – rash

A rash is a rare symptom of mononucleosis. It may appear in the second week of illness. It is macular or maculopapular in nature, similar to the scarlet fever rash. The location of the rash in mononucleosis is most often the torso. If the rash appears after antibiotics, it appears on a larger area of ​​the body, including the hands, feet, limbs, face and even the auricles outside the body.

Also read: How to recognize an allergic rash? Causes, symptoms and treatment of skin allergies

Mononucleosis – when to see a doctor?

It is recommended that you see your doctor if you develop symptoms of mononucleosis so that a specialist can make a diagnosis and rule out other conditions that may have different treatment recommendations.

Besides Epstein-Barr virus (EBV), other viruses can cause symptoms similar to mononucleosis. These include cytomegalovirus (CMV), adenovirus, human immunodeficiency virus (HIV), rubella, hepatitis A, and human herpesvirus type 6. Toxoplasma gondii can also cause monosimilar symptoms. If a woman is pregnant or may become pregnant, some of these other conditions may put her or her baby at risk. In this case, the woman must be carefully examined to identify the cause of the symptoms of mononucleosis.

It should be remembered that after diagnosis, it is possible to develop other diseases that require medical attention. For example, you can get angina. If we or our child have persistent severe sore throats, or swollen tonsils that make it difficult to breathe or swallow, we should see a doctor. You can diagnose streptococcal pharyngitis with a streptococcal rapid test. Antibiotics are needed to heal the angina and avoid complications. It is also recommended that you see your doctor if you have breathing problems due to enlarged tonsils.

The symptoms of mononucleosis usually go away after four to six weeks. If they persist, see your doctor as there may actually be another problem. Your doctor may perform additional tests to identify the cause of your symptoms.

Also read: Hepatitis A on the attack. Are we in danger of an epidemic?

Mononucleosis – diagnosis

A doctor may suspect mononucleosis based on the patient’s symptoms, their duration, and a physical examination. A specialist will look for symptoms such as swollen lymph nodes, tonsils, liver, or spleen and consider how these symptoms relate to the symptoms the patient describes.

In addition, the doctor may perform blood tests.

1. Antibody tests. If there is a need for additional confirmation of mononucleosis, a screening test to check the blood for antibodies to the Epstein-Barr virus may be performed. The screening test gives you results within one day. However, it may not detect an infection in the first week of illness. Another antibody test takes longer to test results, but may even detect disease within the first week of symptoms.
2. White blood cell count. Your doctor may do other blood tests to check for an increased number of white blood cells (lymphocytes) or abnormal-looking lymphocytes. These blood tests will not confirm mononucleosis, but may suggest it as a possibility.

See also: Is SARS-CoV-2 antibodies worth testing? [WE EXPLAIN]

Infectious mononucleosis – treatment

Usually, mononucleosis is mild and self-limiting, although drug therapy is the key to relieving symptoms, reducing fever, and improving the patient’s condition. If the doctor finds bacterial superinfections in a patient with mononucleosis, he may prescribe appropriate antibiotics.

However, it happens that patient with mononucleosis requires hospitalization. Such a need arises especially when the taken antiviral preparations do not bring any improvement. In this situation, your doctor may decide to give you steroids. During treatment, it is important to keep a high temperature, drink plenty of fluids and rest (mononucleosis is a grueling condition). In addition to the above-mentioned activities, it is also worth paying attention to the diet, which should be rich in vitamins and easy to digest.

1. Can mononucleosis cause breast cancer? Check

What should not be used to treat mononucleosis?

In no case should antibiotics be used, due to the viral etiology of the disease. Interestingly, in patients with infectious mononucleosis, penicillin antibiotics such as ampicillin or amoxicillin may cause an allergic reaction in the form of a rash. It is also worth emphasizing that a vaccine for mononucleosis has not yet been inventedand the person who has had the disease once is still a carrier.

Mononucleosis – home remedies

In addition to getting plenty of rest, the steps below can help ease the symptoms of mononucleosis.

1. Consuming plenty of water and fruit juices. Fluids help relieve a fever and sore throat and help prevent dehydration.
2. Taking over-the-counter painkillers. If necessary, use painkillers such as acetaminophen or ibuprofen. These drugs do not have antiviral properties. They should only be taken to relieve pain or a fever. Caution should also be exercised when administering aspirin to children and adolescents. Although aspirin is approved for use in children over 3 years of age, children and adolescents after chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition in such children.
3. Salt water rinses. You should do them several times a day to relieve a sore throat. To do this, mix 1/4 teaspoon (1,5 grams) of salt in approximately 250 milliliters of warm water.

Mononucleosis – recovery period

Mononucleosis is a disease that makes the body very weak. A high fever that persists for a long time, pain in enlarged lymph nodes and the long presence of the virus in the blood are very noticeable to a person. Malaise, weakness and constant fatigue may persist for several weeks after recovery. During this period, it is necessary to take more care of yourself, rest and sleep, so that the body can regenerate its strength. The more you rest, the faster you should recover. Returning to daily activities too early may increase the risk of the disease coming back.

W the recovery period after mononucleosis physical exertion is not recommended, and abdominal injuries should be avoided, because the spleen, enlarged during the disease, protrudes from the ribs that protect it and can easily break. A rupture in the spleen causes severe bleeding and requires urgent medical attention. It’s best to ask your doctor when it is safe to return to your normal level of activity. Your doctor may recommend a gradual exercise program to help you rebuild your strength while you recover.

It is recommended that a complete blood count is performed after mononucleosis has resolved to rule out anemia and to check the blood count. The DrDiagnoza.com medical center offers a package of blood laboratory tests for women and men. The examination will allow you to quickly assess the state of health after the disease.

Mononucleosis – how to deal with the recovery period?

Mononucleosis can last for weeks, keeping a patient at home while he or she recovers. You should be patient as the body fights the infection.

For young people, mononucleosis will mean missing activities, activities and parties. Undoubtedly, the sick person will need a little rest. If you have mononucleosis, you don’t necessarily need to quarantine. Many people are already immune to the Epstein-Barr virus from childhood exposure. However, it is advisable to stay home and not to go to school or other activities until you feel better.

Mononucleosis – prognosis

Recovery from the acute stage of initial EBV infection in healthy and immunocompetent individuals is usually complete within a few weeks, but recovery may take several months. Prolonged lethargy, fatigue, and joint pain are common, often lasting 6 months or more.

EBV causes infection throughout life because the virus remains dormant in B lymphocytes. An intact immune response prevents progressive EBV disease. However, immunosuppression or other disease can reactivate the virus, causing vague and subclinical symptoms and, rarely, aggressive disease. During this phase, the virus can spread to other people.

Also read: Are you experiencing disturbing symptoms? Take a short medical interview and get your health checked

Complications after infectious mononucleosis

Serious complications are rare as a result of mononucleosis, but bacterial infections are quite common.

Complications of mononucleosis can develop and can be quite serious. They include:

1. Anemia: Mononucleosis can cause red blood cells to die and be removed from the bloodstream by the spleen faster than usual. The bone marrow may not be able to keep up with this faster rotation, causing anemia.
2. Hepatitis with jaundice: Liver involvement is usually mild, but for this reason you should not drink alcohol if you have symptoms of mononucleosis.
3. Spleen rupture: The spleen may enlarge due to monotherapy and, although rarely, may subsequently rupture – an emergency that can result in massive, often life-threatening internal bleeding. It is important to avoid contact sports and strenuous activities when suffering from mononucleosis as they can cause this complication. The spleen is not essential for a normal life, but we may be more likely to become infected Streptococcus pneumoniae and some other germs if our spleen is removed.
4. Nervous system complications: although rare, the nervous system can also be affected by mononucleosis. Related complications include Guillain-Barré syndrome, seizures, meningitis, and facial paralysis (Bell’s palsy).
5. Uncontrolled reactivation of EBV infection: This is rare, but people with a weakened immune system due to HIV, organ transplant immunosuppressive therapy, or X-linked lymphoproliferative disorders can get uncontrolled reactivation of EBV infection and die from mononucleosis.
6. Heart inflammation: The most common (though still rare) cardiac complication associated with mononucleosis is inflammation of the sac around the heart, known as pericarditis. This can lead to atrial fibrillation. The virus can also infect the heart muscle and cause inflammation of the heart muscle.

There are also specific complications to be aware of for specific groups of people:

Complications of mononucleosis in children

Airway obstruction by enlarged tonsils is possible in young children and may require hospitalization. A pediatrician may confuse the symptoms of mononucleosis for a bacterial infection (such as angina) and prescribe an antibiotic such as ampicillin, amoxicillin, or a related penicillin. These antibiotics will not work because mononucleosis is a viral infection. Moreover, children sometimes develop a nasty rash as a result of the action of these drugs.

Complications of mononucleosis in pregnant and lactating women

Epstein-Barr virus-induced infectious mononucleosis appears to have little or no effect on pregnancy outcomes, although there is some correlation with early delivery and lower birth weight. Some women may reactivate EBV infection during pregnancy. It is possible that Epstein-Barr will be passed on to your newborn during delivery. However, infants often have no symptoms when they become infected with EBV, so this is not a health issue. Breast milk can contain the virus, but it is unclear whether this could cause an infection in your baby.

Sometimes other negative effects of the disease are also observed, including inflammation of the pancreas, testicles, heart and brain.

Mononucleosis – prophylaxis

Mononucleosis is spread through saliva. An infected person can prevent the spread of the virus to other people by not kissing them or sharing food, utensils, glasses and cutlery with them for several days after the fever improves – and even longer, if possible. Also, be sure to wash your hands regularly to prevent the spread of the virus.

The Epstein-Barr virus can persist in saliva for several months after infection. There is no vaccine to prevent mononucleosis.

See also: Washing your hands can protect against viruses. How to do it effectively?

Mononucleosis – other information

1. In 99–96% of adults, the presence of antibodies indicating contact with EBV is found.
2. The mildest course of mononucleosis occurs in children and adolescents, and the most severe in adults over 35 years of age.
3. Mononucleosis virus (EBV) may contribute to the formation of a cancer of the blood system (Burkitt’s lymphoma). It is worth mentioning that there is no association between developing mononucleosis and an increased risk of developing lymphomas.
4. People who have had mononucleosis develop permanent immunity to the Epstein-Barr virus. However, they are its carriers until the end of their lives. EBV lives in the body in a latent form.
5. Children should be taught from an early age not to share cutlery or drink from the same glass / mug. Before the first symptoms of mononucleosis appear, EBV is already present in saliva and an infected person can become contagious. It is said that even six months after the symptoms have disappeared, the virus is still present in the saliva and is still a threat.
6. Good hygiene is required to avoid contracting mononucleosis.