How serious is mono in a child

Mononucleosis (Mono) (for Parents) - Nemours KidsHealth

What Is Mononucleosis?

Mononucleosis (mono) is a viral infection that causes a sore throat and fever. Cases often happen in teens and young adults. It goes away on its own after a few weeks of rest.

What Causes Mono?

Mononucleosis (mah-no-noo-klee-OH-sus), or infectious mononucleosis, usually is caused by the Epstein-Barr virus (EBV). Most kids are exposed to EBV at some point while growing up. Infants and young kids infected with EBV usually have very mild symptoms or none at all. But infected teens and young adults often develop the symptoms that define mono.

Other viruses, such as cytomegalovirus, can sometimes cause a mono-like illness too.

What Are the Signs & Symptoms of Mononucleosis?

Signs of mono usually show up about 1–2 months after someone is infected with the virus. Its most common symptoms are sometimes mistaken for strep throat or the flu. These include:

fever
sore throat with swollen tonsils that may have white patches
swollen lymph nodes (glands) in the neck
being very tired

A person also can have:

headaches
sore muscles
weakness
belly pain with a larger-than-normal liver or spleen (an organ in the upper left part of the belly)
skin rash
loss of appetite

Is Mono Contagious?

Mono is contagious. It spreads from person to person through contact with saliva (spit). It's nicknamed "the kissing disease" because it can spread through kissing. It also spreads through coughing and sneezing, or when people share something with spit on it (like a straw, drinking glass, eating utensil, or toothbrush).

Mono can also spread through sexual intercourse and blood transfusions, but this is much less common.

People who've been infected carry the virus for life, even after symptoms stop and even if they had no symptoms. The virus is then "dormant," or inactive. Sometimes the dormant virus "wakes up" and finds its way into a person's saliva. This means that they can be contagious from time to time, even when they have no symptoms.

How Is Mono Diagnosed?

To diagnose mono, doctors do an exam to check for things like swollen tonsils and an enlarged liver or spleen, common signs of the infection. Sometimes the doctor will do a blood test.

How Is Mono Treated?

The best treatment for mono is plenty of rest and fluids, especially early in the illness when symptoms are most severe. There is no specific medicine for mono, but acetaminophen or ibuprofen can help to relieve fever and aching muscles. Antibiotics will not help, because they're only effective against bacteria. Someone with mono who takes an antibiotic often ends up getting a rash.

Never give aspirin to a child who has a viral illness because its use has been linked to Reye syndrome, which may cause liver failure or even be fatal.

How Long Does Mono Last?

Mono symptoms usually go away within 2 to 4 weeks. In some teens, though, the tiredness and weakness can last for months.

Can Mono Be Prevented?

There is no vaccine to protect against the Epstein-Barr virus. But you can help protect your kids from mono by making sure that they avoid close contact with anyone who has it.

Many people who have mono won't have symptoms, but they can still pass it to others. So kids should wash their hands well and often, and not share drinks or eating utensils with others, even people who seem healthy.

What Else Should I Know?

Mono can make the spleen swell for a few weeks or longer. An enlarged spleen can rupture, causing pain and bleeding inside the belly, and needs emergency surgery. So doctors recommend that kids who have mono avoid contact sports for at least a month after symptoms are gone. Your child should stay away from rough play, heavy lifting, and any strenuous activities until the doctor says it's OK.

In most cases, mono symptoms go away in a matter of weeks with plenty of rest and fluids. If they seem to linger or get worse, or if you have any other questions, call your doctor.

What's Mono? (for Kids) - Nemours KidsHealth

Have you ever heard of the "kissing disease"? If you said that it's mono, you're right!

Infectious mononucleosis, called mono for short, is usually caused by the Epstein-Barr virus (EBV). EBV is one of the most common viruses around. Most people will get infected with it at some point in their life. Babies and young kids who get infected with EBV often don't feel any symptoms, or sometimes they have mild symptoms that feel like a common cold.

But older kids and teenagers who get infected with EBV are likely to feel symptoms such as fever and a very sore throat.

How Do Kids Get Mono?

Mono is contagious, which means someone who has it can spread the virus to other people. Even though it's called the kissing disease, there are other ways you can get mono. They usually involve contact with saliva (spit). So sharing straws, toothbrushes, or food from the same plate can spread mono.

At first, people don't feel sick after getting infected with the EBV virus. The symptoms come a month or two later. And some people don't get any symptoms at all. So they can spread the virus and not even know it. That's why it's important not to share things like forks, straws, water bottles, or lip gloss at school.

What Are the Signs of Mono?

Mono can cause you to feel really, really tired, but you may have other symptoms, too. These include:

fever
sore throat
swollen lymph glands in your neck
headaches
sore muscles
belly pain with enlarged swollen liver or spleen (organs in the upper part of your belly)
loss of appetite

It may seem like you have the flu or strep throat because the symptoms are so much alike. The only way to tell for sure if you have mono is to go to a doctor, who will do an exam to see if you have mono. Sometimes the doctor will do a blood test to be sure.

What If I Have Mono?

If you have mono, you probably will need plenty of rest. This might mean no school for a while, no sports, and no running outside playing with friends or even wrestling with your little brother.

While you're resting, drink plenty of water and other fluids. You can ask your mom or dad to give you a pain reliever if you have a fever, sore throat, or aching muscles. Don't take any aspirin, though, because that can put you at risk for a condition called Reye syndrome, which can be dangerous.

Some kids with mono might not feel very sick at all. But it's very important to listen to your body. A kid who has mono should tell a parent if he or she starts feeling worse. And if the kid feels tired and run down, it's the body's way of saying more rest is needed.

Kids who play contact sports (like football or basketball) need to skip them for about a month after the illness, especially if their spleen is swollen. Your doctor will let you know when it's safe for you to get back in the game.

Mono usually goes away after a few weeks, even though you'll have to take it easy for a bit. Make sure you wash your hands after you cough or sneeze. Keep your straws, forks, and toothbrushes to yourself, and… no kissing for a few months!

Infectious mononucleosis

The causative agent of mononucleosis is DNA-genomic Epstein-Barr virus of the herpesvirus family (Herpesviridae). Divided into two types A and B, which are similar in symptoms and course of the disease.

Herpesvirus is widespread - 50% of children are carriers, among adults the incidence reaches 90%. In the vast majority of cases, a person is a carrier. Symptoms do not appear. Such a person is called seropositive or seropositive.

Sometimes the disease causes serious complications: airway obstruction, closed damage to the soft tissues of the spleen and neurological syndromes. The main diagnostic method is serological analysis. Therapy is symptomatic and supportive. Once an infected person becomes a carrier of the virus for life.

Ways of transmission

The virus does not live outside the human body. Dies at high temperatures and from disinfectants. It is transmitted by body fluids and airborne droplets through close contact of a healthy and seropositive person. Infection occurs in both acute and chronic phases.

The most common method of transmission is a kiss , the rarest is through a blood transfusion. You can become infected when using shared dishes, clothes, bed linen and towels. Outbreaks of the disease occur in crowded places: hostels, small families, children's institutions. Most often, herpesvirus is detected in low-income social groups, due to cramped living conditions.

Symptoms of mononucleosis

In young children under 5 years of age, primary EBV infection is usually asymptomatic. Symptoms of infectious mononucleosis often develop in adolescents, slightly less often in adults. The average incubation period is 40 days. At this time, the patient experiences increased fatigue.

The disease proceeds in 3 phases:

Fever - the temperature rises during the day, reaching its peak in the evening. Reaches +40 C, but may be higher, subsides in the morning.
Pharyngitis (inflammation of the pharynx and tonsils) is severe, with severe pain. The mucous membranes turn red, swell, and exudate may form.
Adenopathy - generalized enlargement of the lymph nodes. You can notice changes visually and on palpation of the posterior and anterior cervical lymph nodes, submandibular, axillary and inguinal. The lesion is symmetrical, can be observed on any group of nodes. In some cases, adenopathy may be the only sign of infection.

Depending on the individual characteristics of the body and the presence of other diseases, mononucleosis in some people can cause the following symptoms:

Splenomegaly - enlargement of the spleen, occurs in 50% of cases.
Hepatomegaly - an increase in the size of the liver, pain when tapping.
Other symptoms include: yellowness of the integument, swelling around the eyes, ruptured capillaries (petechial rash).

Complications

With primary infection, the Epstein-Barry virus can be asymptomatic in the body, and in some cases cause serious consequences. First of all, these are respiratory complications.

Upper airway obstruction - the lymph nodes may enlarge to such a size that breathing becomes difficult.
Pulmonary infiltrates - replacement of a section of the lung with normal airiness for denser enlarged tissues. More common in young children.

Complications of mononucleosis may affect individual organs:

Liver. In 95% of patients, the level of aminotransferase increases by 2-3 times. The skin may become slightly icteric. The liver will be enlarged, painful on percussion.
Spleen. In mononucleosis, the spleen and capsules increase significantly in size, which leads to rupture. Maximum swelling occurs 10 to 21 days after infection. On average, a complication is observed in half of the patients. The rupture may be painful or may be painless with hypotension (low blood pressure).

Hematological complications are also noted, which, as a rule, do not require medical intervention and stop on their own. This includes:

Granulocytopenia is a decrease in the content of granulocytes in the peripheral blood.
Thrombocytopenia - a decrease in the number of platelets, an increase in the risk of bleeding.
Hemolytic anemia is the premature breakdown of red blood cells.

Similar symptoms are observed in 50% of patients. In rare cases, hematological complications are severe, can lead to bacterial infections.

The nervous system also suffers from EBV. In extremely rare cases, against the background of infectious mononucleosis, encephalitis, Guillain-Barré syndrome, cranial nerve palsies, meningitis, myelitis can develop.

Diagnostics

Analysis for heterophile antibodies.
Serological analysis for the Epstein-Barr virus.

To perform these tests, it is necessary to assume the presence of infectious mononucleosis virus by typical features. These symptoms include swollen lymph nodes in the back of the neck or generalized adenopathy associated with enlarged liver and spleen, exudative pharyngitis, and high fever.

You should also pay attention to diseases similar in symptoms and exclude them.

Differential

When diagnosing, it is necessary to make sure that the patient has a herpes virus, since there are several infections similar to EBV. Among them:

Primary HIV infection. It can be ruled out by testing for quantitative determination of HIV RNA in plasma and combined enzyme immunoassay for antibodies and p24 antigen.
Primary HIV infection has symptoms similar to EBV. All patients at risk must be tested for HIV without fail.
Cytomegalovirus. Similar to EBV in everything except pharyngitis. To exclude this disease, serological testing, analysis for antigens or CMV DNA is necessary.
Toxoplasmosis. A parasitic disease, which, like cytomegalovirus, differs from mononucleosis in the absence of pharyngitis. For differentiation, he conducts serology of blood serum, an analysis for the level of IgG antibodies.

In practice, there are cases of simultaneous infection with several types of viruses that are in the body in the active phase. Differentiation is also carried out with treatment failure, long-term course of the disease, with insufficient results for remission.

Laboratory methods for the diagnosis of mononucleosis

The main criterion in making a diagnosis is a serological analysis for EBV. Atypical lymphocytes may be present in influenza, hepatitis B, HIV, cytomegalovirus, and other viral diseases. But, only with primary mononucleosis, they are produced in very large quantities.

Serological analysis confirms the test for specific (heterophilic) antibodies to EBV. The most productive research is when working with biological materials of adolescents and adults. In children under 5 years of age, it shows a positive result in only 50% of cases.

Important to know! In HIV-infected people, the analysis for heterophile antibodies may be false positive. It is recommended to conduct the study twice with a break of 7-10 days.

The presence of IgG antibodies to EBV VCA indicates primary EBV infection. They can be detected from the first days of infection within three months. Antibodies to EBV-IgG are produced later, approximately 2 months after the onset of the disease. They remain in the blood throughout a person's life.

Instrumental diagnostics

The following types of instrumental diagnostics are used to make a diagnosis, assess the severity, and monitor therapy:

ultrasound examination of the organs of the peritoneum;
electrocardiogram;
chest x-ray;
echocardiography;
neurosonography;
electroencephalography;
radiograph of the paranasal sinuses.

An instrumental examination of the patient allows, by determining the size of the liver, spleen and lymph nodes, to assess the severity of the disease: mild, moderate, severe. When making a diagnosis of "infectious mononucleosis", indicate the specifics of the course of the disease: clinical, nosological form, severity, duration. In a separate line enter the presence of complications and concomitant diseases.

Treatment of infectious mononucleosis

supportive therapy.
Corticosteroids for severe disease.

Treatment of infectious mononucleosis is aimed at stopping palogolic processes, preventing their development in the future, preventing complications, residual effects and the chronic course of the disease.

First of all, the patient needs to ensure peace. During the period of enlargement of the spleen, physical activity and sports are prohibited. Heavy lifting should be avoided to reduce the risk of ruptured spleen. To reduce symptoms and speed up recovery, methods of drug and non-drug treatment are used.

The preparations of etiotropic, symptomatic therapy and immunocorrection are shown:

interferons;
immunoglobulins;
nucleosides and nucleotides other than reverse transcriptase inhibitors;
derivatives of propionic and acetic acid;
triazole derivatives;
adrenomimetics;
antibiotics;
macrolides;
glucocorticoids;
solutions that affect the water-electrolyte balance for detoxification;
mucolytic drugs and others, depending on the symptoms.

Antibiotics are prescribed only for viral and bacterial infections, confirmed by microbiological diagnostics. If there are complications, corticosteroids may also be prescribed. It is believed that they help to quickly get rid of the fever and reduce the manifestation of pharyngitis. They are useful for complications such as the threat of airway obstruction, hemolytic anemia, thrombocytopenia.

The most effective methods of non-drug treatment include physiotherapy, sanitation of the nasal passages, and frequent airing of the room. Depending on the degree of the course of the disease, treatment can be carried out on an outpatient basis and in a hospital.

Prognosis and prevention

In most healthy people, the acute phase of infectious mononucleosis resolves on its own. However, a person forever remains a carrier of the virus. Severe course and complications are observed in 10-20% of cases, depending on the age group. The presence of chronic diseases and immunodeficiency states increases the risk of a severe course of the disease. Mortality is low, less than 1%, due to complications that have developed against the background of infection: airway obstruction, encephalitis, rupture of the spleen.

The duration of the acute phase of the disease is about 2 weeks. After this period, if asymptomatic, the patient may return to school or work. Among the indications for discharge: normalization of temperature, no signs of intoxication and inflammation in the nasopharynx, normalization of the size of the lymph nodes, liver and spleen. However, it is necessary to continue a gentle sleep-wake regimen, to avoid increased mental and physical stress. High fatigue will persist for several more weeks, in some patients for many months.

After mononucleosis, the body's sensitivity to respiratory diseases and the herpes virus increases. Many note the onset of frequent lesions of the skin of the upper or lower lip after recovery from EBV.

Benefits of laboratories JSC "NWDM"

Our own laboratory and advanced equipment guarantee fast and accurate results.
Qualified employees and friendly staff - anonymity, comfortable stay, no queues.
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Several ways to get the results - in person, via the e-mail specified during registration.

You can get tested for infectious mononucleosis in St. Petersburg, the Leningrad Region, Veliky Novgorod, Staraya Russa, Okulovka, Kaliningrad and Pskov.

What is mononucleosis and how to treat it

January 28, 2020 Likbez Health

If your cold doesn't go away, it might be the Epstein-Barr virus.

What is mononucleosis and where does it come from

Mononucleosis is an infectious disease that is transmitted through saliva (in the vast majority of cases). That is why it is also called the “kissing disease”.

You can really get mononucleosis by kissing. But another route of infection is no less likely: if you share common utensils (cups, glasses, spoons, forks) with an already infected person, share a common piece of bread, pizza or an apple, on which particles of saliva remain. Young children often catch this disease in the garden - for example, when they put a toy in their mouth that was slobbered by another child.

Mono is not as contagious as the common cold. The Epstein-Barr virus that causes the disease quickly dies in the external environment. In fact, it remains alive and active only as long as the saliva is moist. Therefore, you can only become infected through close contact.

According to American statistics, by the age of 40, up to 90% of adults have had mononucleosis one way or another.

However, with such a significant plus (low contagiousness), the “kissing disease” has a significant minus: it can lead to much more serious consequences than common SARS.

How to recognize mononucleosis

Usually, mononucleosis is not a serious disease, does not cause severe symptoms, and goes away on its own. True, recovery takes a longer period than with a common cold - from two to four weeks (in rare cases - up to six months).

During this period, the patient may experience the following symptoms:

Weakness, fatigue.
Sore throat. She is sometimes misdiagnosed as acute pharyngitis, but does not respond to antibiotic treatment prescribed in such cases.
Fever - an increase in temperature to 37.8 ° C or more.
Enlarged lymph nodes in the neck and armpits.
Swollen tonsils.
Headache.
Eruptions on the skin. In this case, the rash does not have a clear location: it can occur throughout the body. But most often it appears on the face and chest.
Enlarged spleen and liver.
Reduced immunity. With mononucleosis, a person easily catches other infections - those from which in "healthy times" his body would easily fight off.

Due to the similarity of symptoms, mononucleosis is often confused with SARS. But if your “common cold” dragged on for 1-2 weeks, be sure to consult a therapist: perhaps it is the Epstein-Barr virus.

Why mononucleosis is dangerous

Complications are rare, but it is important to know about them in order to seek help in time.

1. Swollen tonsils

Sometimes the swelling is so great that the tonsils can block the airways. If it becomes difficult to swallow, breathing quickens and becomes hoarse, immediately contact a therapist or even call an ambulance - it all depends on the severity of the symptoms.

2. Rupture of the spleen

Enlargement of the spleen is one of the most common symptoms of mononucleosis. In some cases, the spleen may rupture due to swelling, causing sudden, sharp pain in the upper left abdomen.

If you feel something like this, call an ambulance immediately: an emergency operation is most likely required.

3. Liver problems

Mononucleosis can provoke an inflammatory process in the liver - hepatitis. This situation can be recognized by the manifestation of jaundice - yellowing of the skin and whites of the eyes. At the first sign of it, you should immediately consult a doctor.

An inflamed liver needs treatment and a diet (the therapist or gastroenterologist will tell you more specifically).

However, sometimes there are anicteric forms of hepatitis. Therefore, it is important to diagnose mononucleosis in time and carefully monitor the condition of the liver.

4. Blood problems

Sometimes mononucleosis causes the destruction of red blood cells, the oxygen-carrying red blood cells. In this case, there is a so-called hemolytic anemia.

Platelets, the blood cells responsible for blood clotting, can also be affected. A decrease in their number is called thrombocytopenia.

5. Heart problems

An irregular heartbeat (arrhythmia) or inflammation of the heart muscle (myocarditis) is another possible (though rare) complication of mononucleosis.

6. Damage to the nervous system

Also, in rare cases, Epstein-Barr virus can cause convulsions, inflammation of the brain (encephalitis) or tissues covering it (meningitis).

How to treat mononucleosis

Given the possible complications, it is best to be under medical supervision. Since the disease is caused by a virus, there is no cure for it. Treatment is only to relieve the symptoms.

Get more rest. Ideally, take sick leave and lie down at home until weakness and fever pass.
Drink more fluids - water, compotes, fruit juices. Moisture helps reduce fever, sore throat and prevents dehydration.
If your throat hurts badly, take an over-the-counter pain reliever. For example, based on paracetamol or ibuprofen.
Gargle with salt water (½ teaspoon of salt in a glass of warm water) 2-3 times a day. This will also reduce pain.

If the symptoms do not improve (and even more so if they become more pronounced), be sure to tell your doctor about them.

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