Infectious mononucleosis

Infectious mononucleosis is a common systemic proliferative disease. The harm caused by infectious mononucleosis is very great. If infectious mononucleosis is not treated in time, it may even turn into cancer. In fact, infectious mononucleosis can be found in daily physical examinations. So what are the methods for diagnosing whether you have infectious mononucleosis?

【Overview】

Infectious mononucleosis is an acute proliferative disease of the mononuclear-macrophage system that is often self-limited. Clinically, the disease manifests as irregular fever, swollen lymph nodes, sore throat, a significant increase in peripheral blood monocytes, abnormal lymphocytes, positive heterophile agglutination test, and detectable anti-EB virus antibodies in the serum. About half of primary EBV infection in young people and adults presents with infectious mononucleosis. Burkittis lymphoma (BL) and nasopharyngeal carcinoma in African children only occur in patients who have been infected with Epstein-Barr virus. Both BL and nasopharyngeal carcinoma tumor cells carry EB virus DNA and virus-determined nuclear antigens. Therefore, EB virus may be an important pathogenic factor of BL and nasopharyngeal carcinoma.

【diagnosis】

Sporadic cases are easily overlooked. The diagnosis is mainly based on clinical symptoms, typical blood pictures and positive heterophile agglutination test, especially the latter two. When an epidemic occurs, epidemiological data have great reference value.

When it is difficult to conduct serological examinations, a diagnosis can be made based on blood counts combined with clinical findings. Although high fever, pharyngitis, and cervical lymphadenopathy are common clinical manifestations, they are not necessarily present. Serum alanine aminotransferase usually rises during the course of the disease, even in the absence of jaundice, which deserves attention. Typical blood picture and heterophile agglutination test will change or be positive on the second day of the disease, but significant changes are generally seen between the first and second weeks. The heterophile agglutination test may not reach a meaningful level until several months later. Therefore, the importance of repeated examinations must be emphasized. 1 to 2 negative results cannot negate the diagnosis.

【Treatment measures】

The treatment of this disease is symptomatic and the disease can mostly heal itself. During the acute phase, especially when complicated by hepatitis, you should rest in bed. Antibiotics are ineffective for this disease and can only be used when secondary bacterial infection of the pharynx and tonsils occurs. Penicillin G is generally appropriate and the course of treatment is 7 to 10 days. If ampicillin is given, about 95% of patients may develop a rash, usually occurring one week after medication or after medication discontinuation. This may be related to the immune abnormality of this disease, so ampicillin should not be used in this disease. Some people believe that metronidazole and clindamycin may be helpful for the pharyngitis of this disease, suggesting the possibility of concurrent anaerobic infection, but clindamycin can also cause rash. Adrenal cortical hormones are indicated for patients with severe lesions or edema in the pharynx and larynx. They can quickly reduce inflammation, and timely use can avoid tracheotomy. Hormones can also be used in patients with central nervous system complications, thrombocytopenic purpura, hemolytic anemia, myocarditis, pericarditis, etc.

We should always be alert to the possibility of splenic rupture. Timely diagnosis, rapid blood volume replenishment, blood transfusion and splenectomy can often save the patient.

Acyclovir and its derivatives have antagonistic effects on Epstein-Barr virus in in vitro tests, but such drugs do not have to be routinely used in general patients with infectious mononucleosis. Only AIDS patients with oral hairy leukoplakia and those with sufficient evidence of chronic progressive Epstein-Barr virus infection may consider using such preparations. The efficacy of interferon is unclear.

The above is an introduction to some common sense about the diagnosis, symptoms, hazards, and treatment of infectious mononucleosis. I hope it will be helpful to all my friends. Finally, I would like to remind you that if you find any discomfort in your body in daily life, you must seek timely treatment to reduce the pain of the disease.