Mononucleosis is a common infectious disease that occurs acutely and affects the lymph nodes and internal organs. At the same time, the reaction of the blood also changes.
Mononucleosis in adults: historical data
For a long time, the disease was considered only as a lymphatic reaction on the basis of other infections. His independent clinical picture was first described in 1885 by N. F. Filatov. He drew attention to the fact that the basis of the disease is an increase in the lymph nodes, and called it glandular fever. For several years, mononucleosis was described as monocytic tonsillitis and other infections. The disease received its current name only in 1902.
Mononucleosis in adults: etiology
The causative agent of 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 reproduction. Virus particles contain several antigens, each of which is formed in a certain order. Then, in the same order, to each of them in the blood of the diseasedcorresponding antibodies are synthesized.
In the external environment, the virus is almost unstable, and when dried, high temperature and exposure to disinfectants, it dies altogether.
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 is so mild that the person does not seek medical help. But more often it still begins with a gradual or sharp fever. The patient has a severe headache, which raises suspicions of meningitis. The feverish period can last as little as 4 days, or it can last up to two months.
A constant symptom of the disease is an increase in lymph nodes. Those that are located along the posterior edge of the sternocleidomastoid muscle are most clearly affected. The nodes are painful to the touch. In three or four days they reach the size of a walnut. Other glands (inguinal, mesenteric, axillary, mediastinal) may also be involved.
In most cases, the spleen enlarges and hardens. It does not cause pain on palpation.
The next symptom is a sore throat. It may be absent in rare cases. Angina can manifest itself both 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, adult mononucleosis is difficult to differentiate from pharyngeal diphtheria. And, of course, the cardinal symptom -blood change. Already at the beginning of the disease, leukocytosis is observed. 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 symptoms disappear after 10-15 days, but sometimes even after the fever has stopped, the lymph nodes and spleen remain enlarged for a long time, and the change in blood composition also lingers.
Mononucleosis: diagnosis
In laboratory conditions, the recognition of the disease occurs on the basis of a reaction to heterophile antibodies. The fact is that by the end of the first week, hemagglutinins to the erythrocytes of some animals sharply increase in human blood. Mononucleosis in adults must be differentiated from many other diseases. So, from Vincent's angina and diphtheria, it is distinguished by a characteristic formula of leukocytes and an enlarged spleen. From tularemia - the presence of atypical cells in the blood.
