Infectious mononucleosis in adults

The disease mononucleosis refers to common infectious diseases that occur acutely and affect the lymph nodes and internal organs. At the same time, the reaction of blood changes.

Mononucleosis in adults: historical data

For a long time the disease was considered only as a lymphatic reaction to the soil of other infections. His independent clinical picture was first described in 1885 by N. F. Filatov. He drew attention to the fact that the disease is based on enlarged lymph nodes, and called it a glandular fever. For several years mononucleosis has been described as monocytic angina and other infections. Currently, the common name of the disease was received only in 1902.

Mononucleosis in adults: etiology

The causative agent of the infection is the Epstein-Barr virus, which is able to reproduce even in lymphocytes. It does not lead to cell death, but, on the contrary, provokes their division and multiplication. Viral particles contain several antigens, each of which is formed in a certain order. Then, in the same order, to each of them, appropriate antibodies are synthesized in the blood of the diseased person. In the external environment, the virus is almost not stable, and when it dries up, the heat and the effects of disinfectants are completely destroyed.

Mononucleosis in adults: signs

The range of the incubation period is quite wide: from four days to a month, but on average it lasts a week or two. Sometimes the disease runs so easily that a person does not seek medical help. But more often it still begins with a gradual or severe fever. The patient has a strong headache, which causes suspicion of meningitis. The febrile period can last only 4 days, and may last for up to two months.

A constant symptom of the disease is an increase in lymph nodes. The most distinctly affected are those that are located along the posterior edge of the sternocleidomusus muscle. Nodes are painful when palpated. Day after three or four they reach the size of a walnut. Other glands (inguinal, mesenteric, axillary, mediastinal) can also be involved in the process. In most cases, the spleen is enlarged and compacted. With palpation, it does not cause pain.

The next symptom is angina. It may be absent in rare cases. Angina can manifest itself from the very beginning of the disease, and after a few days. By nature, it can be lacunar, catarrhal or ulcerative diphtheria. In the latter case, mononucleosis in adults is difficult to differentiate from the diphtheria of throat. And, of course, the cardinal symptom is a change in blood. Already at the beginning of the disease, leukocytosis is observed. In this case, the content of mononuclear cells reaches 40-90%. ESR remains normal or increases slightly. There are no deviations from hemoglobin and erythrocytes. In some cases, all the symptoms disappear within 10-15 days, but sometimes even after stopping the fever, the lymph nodes and spleen are prolonged for a long time, and the composition of the blood is delayed.

Mononucleosis: Diagnosis

In the laboratory, the disease is recognized on the basis of a reaction to heterophilic antibodies. The fact is that by the end of the first week, hemagglutinins to the erythrocytes of some animals are rapidly growing in the human blood. Mononucleosis in adults should be differentiated from many other diseases. So, from the angina of Vincent and diphtheria it is distinguished by a characteristic formula of leukocytes and enlarged spleen. From tularemia - the presence in the blood of atypical cells.