Tuesday, April 10, 2012

Infectious mononucleosis


Introduction
Infectious mononucleosis - known popularly as the "kissing disease" or "kissing disease" - has been known for more than a century. An estimated 90% of cases of mononucleosis caused by Epstein - Barr virus (EBV) member group of herpes viruses. Most remaining cases are caused by other herpes viruses, particularly cytomegalovirus infection.

What is it?
Infectious mononucleosis is a viral disease that affects certain blood cells called B lymphocytes. It is an acute disease caused by Epstein-Barr virus characterized by fever, sore throat (pharyngitis), enlarged lymph nodes (lymphadenopathy) and fatigue.

Description of disease
EBV is spread through saliva of an infected person. Kissing and contact with hands or toys that are soaked with infected saliva are common ways of spreading the virus. Early childhood transmission occurs more frequently among lower socioeconomic groups and in places where people are overpopulated. EBV is found in saliva (head and throat) ill and excreted in the saliva of one year after infection. After initial infection, the virus remains within the host for life, and occasionally it can reactivate and exude from the mouth and throat. The spread of viruses is greater in patients with reduced immunity (people infected with HIV or organ recipients).

Who gets it?
While many people are exposed to Epstein-Barr virus in their lives, few of them develop symptoms of infectious mononucleosis. Even 50% of children had a first EBV infection and its 5 years. The majority of infections is almost no symptoms. In adolescents or adults may be almost asymptomatic or recognized as infectious mononucleosis. Although affected men and women, studies show that the disease occurs more frequently in men.In developed countries, the first exposure may be delayed until later childhood and adolescence, when the age is more likely to result in symptoms. For this reason, it appears more in high school pupils and students.

Symptoms
Symptoms appear from four to six weeks after exposure.

Symptoms include:
fever;
sore throat (pharyngitis);
swelling of the lymph glands - lymphadenopathy (especially in the back of the neck);
fatigue.
Usually the patient appears with fatigue lasting several days, and thereafter follows a fever (around 39.5 ° C with the highest values ​​in the afternoon or evening), sometimes severe inflammation of the pharynx (streptokoknoj resembles angina), and enlarged lymph nodes (usually with a symmetrical front and rear the door). Sometimes the affected liver and spleen (increased). They can occur: maculopapular rash, jaundice, swelling of the eyelids and a rash on the NEPS. Symptoms begin 30 to 50 days after exposure. Many people (especially young children) have only mild flu-like symptoms. It is more likely that older children and young people have symptoms. Symptoms may last from one to several weeks. The disease is rarely fatal.

What results can I do?
The right combination of symptoms may indicate infectious mononucleosis, but laboratory tests are necessary for confirmation. In most patients there is an increased number of white blood cells, white blood cells, the increased number of lymphocytes (usually atypical lymphocytes that are morphologically different from the usual). It is available agglutination test on paper "Monospot" test, which indicates whether a patient is infected. A positive result of heterophilic antibodies, Paul-Bunnell test, is sufficient for the diagnosis of infectious mononucleosis. When the Monospot or heterophile tests are negative, further laboratory testing may determine whether the patient is infected with EBV infection or an illness similar to mononucleosis caused by cytomegalovirus, adenovirus, or toxoplasmosis gondi. In general, while laboratory tests are not always 100% specific, serologic tests for EBV are reliable.

Treatment
Mainstay of treatment is to relieve symptoms. Instructions for treatment include:
rest;
Taking plenty of fluids;
in case of sore throat, gargle with salt water or suck throat lozenges, hard candy;
You can take paracetamol, aspirin, ibuprofen or diclofenac for pain relief and fever. Do not give children acetilsalicinu acid because it can result in serious condition called Reye's syndrome. Reye's syndrome is a serious disease that can lead to death. In most cases, no need other treatment than rest.
Forecast
More than 90% of cases of infectious mononucleosis is a safe and uncomplicated, but the fatigue and weakness lasting a month or more are not uncommon. With over 30 years of disease can be severe and last longer. Airway obstruction, rupture (burst) of the spleen, inflammation of heart muscle or tissue that surrounds the heart, and serious complications including bone marrow or central nervous system are rare. These are life-threatening complications, and treated with steroid drugs. Splenic rupture is a life-threatening condition and requires immediate hospitalization, manifested symptoms of shock (a sudden drop in blood pressure, rapid heartbeat, cold sweats, disturbed consciousness).

Prevention
Avoid contact with the saliva of people who have had mononucleosis and people who have recently recovered.Keep your child clean toys and other children outside the mouth. People with recent EBV infection should not donate blood.

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