MONONUCLEOSIS: causes, contagion, symptoms, duration and treatment in children and adults

Infectious mononucleosis is often called the kissing disease. The virus that causes mononucleosis, Epstein Barr Virus (EBV) is transmitted through saliva, and can then be transmitted through kissing. you may also be exposed to the infection through coughing or sneezing, or simply by sharing a glass, dishes, or other items with infected people. If you have contracted mononucleosis, it is important to pay attention to some complications such as an enlargement of the spleen, the development of hepatitis and jaundice with increased transaminases and hyperbilirubinemia. Rest and proper hydration are essential for recovery.

Mononucleosis

Infectious mononucleosis is often called the kissing disease. The virus that causes mononucleosis, Epstein Barr Virus (EBV) is transmitted through saliva, and can then be transmitted through kissing. you may also be exposed to the infection through coughing or sneezing, or simply by sharing a glass, dishes, or other items with infected people. However, mononucleosis is not nearly as contagious as other common infections, such as a cold or the flu.

If you are a teenager or young adult infected with Epstein Barr virus, it is very likely that you can develop mononucleosis with all the common signs and symptoms. In contrast, children and infants usually have few symptoms and the infection is often not recognized.

If you have contracted mononucleosis, it is important to pay attention to some complications such as an enlarged spleen, the development of hepatitis and jaundice with increased transaminases and hyperbilirubinemia. Rest and proper hydration are essential for recovery.

Incubation of mononucleosis

The virus has an incubation period of about 4-6 weeks, although this period may be shorter in young children. Signs and symptoms such as fever and sore throat usually subside over 10 to 15 days, but fatigue, swollen lymph nodes, and splenomegaly can last longer, even for a few weeks.

When to see the doctor? If rest and a healthy diet do not relieve symptoms within a week or two or if symptoms recur, it is prudent to see your doctor.

Causes of mononucleosis

The most common cause of mononucleosis is the Epstein-Barr virus, but other viruses can also cause similar symptoms. mononucleosis syndrome, such as after Cytomegalovirus (CMV) infection. The mononucleosis is usually not very serious. Most adults who have been exposed to the Epstein-Barr virus will have developed antibodies, becoming immune and thus protected from mononucleosis.

Mononucleosis Diagnosis

Physical examination

Doctors may suspect mononucleosis based on the signs and symptoms, their duration, and physical inspection. There may be symptoms and signs such as swollen lymph nodes, enlarged tonsils, enlarged liver - hepatomegaly - or spleen - splenomegaly - as well as fever, loss of appetite, nausea and vomiting.

Blood analysis

Antibody analysis. If it is necessary to further confirm the already suspected diagnosis with the clinic, the Monotest, a quick test to check for heterophile antibodies, a type of immunoglobulins that develop in this type of infection.
To have an additional confirmation, you can make a anti-Epstein-Barr antibodies. This screening test gives results within one day, although it may not detect infection during the first week of illness.
A different antibody test takes a longer result time, but can detect disease even within the first week of symptoms.

Other changes such as a high number of white blood cells (increased lymphocytes or lymphocytosis) or lymphocytes by appearance microscopic abnormal.
Also, there may be an alteration of liver enzymes, with an increase in AST, ALT and GGT, as well as in total and direct bilirubin. These exams of the

Symptoms of mononucleosis

The signs and symptoms of the mononucleosis may include

  • Fatigue
  • Sore throat and redness of the pharynx, which does not improve with the use of antibiotics
  • Temperature
  • Swollen lymph nodes in the neck and armpits
  • Swollen tonsils
  • Headache
  • Rash
  • Soft, swollen spleen

Complications of mononucleosis

Complications of mononucleosis can be more serious than the disease itself. Below is a list of the most frequent complications of mononucleosis.

Splenomegaly - enlargement of the spleen

Mononucleosis can cause the spleen to grow in size. In extreme cases, the spleen can rupture, causing sharp, sudden pain in the left upper abdomen. If such pain occurs, see a doctor immediately, as surgery may be required.

Hepatic dysfunction

Liver problems can also occur:

Hepatitis. You may experience mild inflammation of the liver (hepatitis).
Jaundice. A yellowing of the skin and sclerae, the whites of the eyes, may be observed, linked to an increase in circulating bilirubin.

Less common complications

Mononucleosis may also cause, less frequently, the following complications:

Anemia - a decrease in red blood cells and hemoglobin, an iron-rich protein in red blood cells
Thrombocytopenia - low number of platelets, which are blood cells involved in clotting
Heart problems - inflammation of the heart muscle (myocarditis)
Complications of the nervous system - meningitis, encephalitis and Guillain-Barre syndrome
swollen tonsils - which can make it difficult to breathe
The Epstein-Barr virus can cause much more serious disease in people who have immune system problems, such as people with HIV / AIDS or people taking immunosuppressive drugs due to rheumatological or hematological diseases, or after an organ transplant.

Treatment of mononucleosis

What is the therapy best suited for mononucleosis? There is no available treatment specific for the treatment of infectious mononucleosis. Antibiotics do not work against viral infections such as mononucleosis, on the contrary: the intake of pennicillins, such as the classic Augmentin (amoxicillin + clavulanic acid), exposes the risk of even major skin rashes. THE remedies bed rest, good nutrition and adequate fluid intake are therefore more adequate.

Pharmacological therapy

Occasionally, the treatment of secondary infections, such as a streptococcal (Streptococcal-mediated) infection follows the sore throat of mononucleosis. An infection of the sinuses (sinusitis) or tonsils (tonsillitis) can also develop. If so, antibiotic treatment may be needed for these side bacterial infections.

Care should be taken, as there is a risk of skin rash with some medications. L' amoxicillin and other penicillin derivatives are not recommended for people with mononucleosis. In fact, people with mononucleosis who take any of these drugs could develop a rash that is widespread throughout the body, very annoying and itchy. Please note: the rash, however, it does not necessarily mean that you are allergic to the antibiotic. If necessary, other antibiotics less likely to cause rashes are available to treat infections that may accompany mononucleosis, such as cephalosporins or quinolones.

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