Infectious mononucleosis

The infectious mononucleosis (synonym: glandular fever, limfoadenopatia, macrophage angina, disease Filatova) is an acute infectious disease proceeding with symptoms of intoxication, fever, sore throat, swollen lymph nodes, spleen, rare liver, characterized by changes in leukocyte blood.
The etiology is unclear. Probably the causative agent is a virus.
Epidemiology. Are found everywhere individual (sporadic) cases, less outbreak among schoolchildren, students. The source of infection is a sick person. The disease is transmitted by airborne droplets.
Pathological anatomy. Histological changes are the lymphoid hyperplasia lymph nodes and active proliferation of cells reticuloendothelial.
The clinical picture. The incubation period is from 4 to 30 days. The disease develops more often badly - with a little lightheaded and quick increase of temperature up to 39-40 degrees. Typical symptoms of infectious mononucleosis are fever, a variety of sore throat, enlarged and painful lymph nodes, especially rear-and prenesenie, submandibular, enlarged spleen, and sometimes the liver. Possible catarrhal phenomena of the conjunctiva of the eyes, mucous membrane of the nose, and various skin rash, headache, body aches, diarrhoea phenomenon, and so on, Feverish period lasts from 4 to 8 days to 1 to 2 months. In blood leukocytosis reaches 10 000 - 20 000; dominated by lymphocytes and monocytes (40-90%), appear atypical mononuclear cells with the broad light protoplasm (mononuclear cells). Changes in the blood persist for 2 to 4 months. and more after the normalization of temperature.
Complications: stomatitis, pneumonia, jaundice, serous meningitis, endocarditis, rupture of the spleen, otitis, hemolytic anemia, etc.
The diagnosis is based on the clinical picture of the disease, the results of investigation of peripheral blood and epidemiological data. Serological reaction Paul - Bunnell to identify heterophile antibodies, agglutinating erythrocytes of sheep, is not decisive because of the low specificity. The differential diagnosis should be carried out with angina Vincent (see Angina), diphtheria (see), and in cases proceeding with jaundice,- with the epidemic hepatitis (see Hepatitis epidemic).
The treatment of infectious mononucleosis symptomatic. By prescription in severe cases it can be used steroids (prednisolone); for the prevention of bacterial complications, antibiotics.
Prevention of infectious mononucleosis is early identification and isolation of patients for a period of feverish period. Recovering discharged after the disappearance of the main clinical symptoms at normal body temperature.