mononucleosis, which has as its main symptom fatigue and increase white blood cells, is an infectious disease is not always easy to diagnose. It is spread mainly among young people, usually through saliva, which is why it is also known as kissing desease or "kissing disease."
mononucleosis is caused by a virus called EBV (Epstein-Barr Virus), belonging to the family of herpes viruses, the same as chicken pox and shingles.
Symptoms The main symptoms of mononucleosis are similar to those of a common winter illness include fever, weakness, malaise and enlarged lymph nodes. The incubation period is quite long and varies from 30 to 50 days. Generally is lower in children.
The clinical onset is often preceded by a phase, known as prodromal, in which the symptoms are general and not of particular concern (minor headache, mild fever, anorexia, muscle aches common, perspiration, etc...) If the virus takes over the immune system, mononucleosis proper begins with a more specific phenomenology, whose main elements are represented by fever, pharyngitis (sore throat, difficulty swallowing, possible dehydration) and lymphadenopathy. After a few days we are witnessing the emergence of a large number of atypical lymphocytes in the blood. The asthenia (weakness) is another symptom often found that in some cases lasting for several weeks.
Other symptoms of mononucleosis include: splenomegaly (enlarged spleen) and urticaria. Often there is also a suffering liver, detectable by serological tests.
mononucleosis can cause complications, fortunately rare, out of the central nervous system, and peripheral vascular (hemolytic anemia and thrombocytopenia). Can also involve the heart and lungs.
In some cases the disease manifests itself in a subtle, with little fever and a general sense of malaise and fatigue, which can last for several months. After initial infection, the Epstein-Barr virus remains silent in fact, waiting for the immune system to fall. His subsequent re-activation has been implicated in chronic fatigue syndrome.
The persistent EBV infection has recently been linked also with the onset of Burkitt's lymphoma and other tumor diseases. If the infection occurs during childhood, momonucleosi is usually characterized by mild symptoms are not specific or no symptoms.
Infectivity
mononucleosis is a contagious disease to moderate, which preferentially affects those aged between 15 and 25 years. Spread a little 'all over the world, interested by adolescence 50% of individuals living in industrialized countries, as it appears earlier in those in the developing world. Given the low rate of infectivity, mononucleosis can cause small epidemics only in particular conditions (contact with patients, overcrowding and poor sanitation).
According to recent estimates, in the course of his life about 90% of the adult population with no particular predilection for sex, she came in contact with the Epstein-Barr virus. Most of these people have developed antibodies without ever accused any sign of infection. The signs of mononucleosis gives them only when it strikes debilitated, with a compromised immune system.
The infection can be made through direct and saliva (via oro-pharyngeal), sexual intercourse or blood transfusions and blood products, or indirectly, for example through the use Common contaminated objects such as cutlery, glasses, dishes and toys.
The infectivity can persist for a long time, as the loss of pharyngeal virus persists for up to one year after infection. We must also consider that, during periods of reactivation of the virus, the same carriers can become a source of infection. However, if you have already been infected once, each subsequent contact with a person with mononucleosis will be inconsequential. The disease poses no threat to pregnant women and even there, still, no relationship between infectious mononucleosis and certain birth defects or miscarriages.
Diagnosis Acute infection is diagnosed with mononucleosis clinically the simultaneous occurrence of fever, swollen lymph nodes and sore throat. The definitive diagnosis can only be achieved through the finding of the presence of lymphocytes in the blood characteristic. The same, however, are also found in other diseases such as viral hepatitis, rubella and cytomegalovirus disease. However, while these conditions, the percentage of abnormal lymphocytes is well under 10% in case of mononucleosis, the proportion of atypical lymphocytes falls below this value. In any case, to differentiate the disease from similmononucleosiche syndromes listed above, there are specific immunological tests.
care and treatment in most mononucleosis cases resolved favorably within two or three weeks. Rarely have chronic effects in the coming years, although some patients, however, tend to experience fatigue and difficulty concentrating for several months. After healing, the fact remains latent EBV in lymph node tissue and may reactivate giving rise to the so-called "chronic fatigue syndrome," a state of general debility that can last several months, depriving the subject physical and mental energy (note the ' By analogy with herpes simplex and zoster, responsible, respectively, labial herpes / genital and chickenpox / shingles). To prevent the reactivation of the virus is important to maintain efficiency the immune system with an active lifestyle, free from excessive stress and based on a healthy diet.
The patient suffering from glandular fever should rest in bed and avoid physical exertion for at least a month, especially if there is splenomegaly. The rupture of the spleen by abdominal trauma is indeed a rare complication but fearsome. Those at greatest risk are children and sports, which should also refrain from any efforts for a few weeks after clinical remission. If during the operation, once vigorous palpation, or following an accident were to occur widespread pain left upper abdomen, you should seek immediate medical relief. The
Drug therapy of infectious mononucleosis is based on the administration of analgesics (acetaminophen, ibuprofen) and antipyretics (except acetylsalicylic acid that can cause a serious complication called Reye's syndrome).
Only in severe cases is planed to use for a few days, corticosteroid drug. If still does drugs, treatment of infectious mononucleosis may be used for IgG (immunoglobulin).
Federico Cesareo
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