Dr. Komarovsky on the symptoms and treatment of mononucleosis in children

A common viral infection in children, mononucleosis can be difficult for parents to recognize and treat. Renowned pediatrician Dr. Komarovsky provides insightful information about identifying the signs and comprehending the course of treatment for this condition.

Parents may observe symptoms such as fever, lethargy, and enlarged lymph nodes, but it’s important to know when to get help from a doctor. In order to guarantee a speedy recovery, Dr. Komarovsky stresses the significance of early detection and appropriate care.

This post will examine Dr. Komarovsky’s recommendations for identifying mononucleosis in children and the actions caregivers should take to facilitate their children’s proper healing.

About the disease

The virus that causes infectious mononucleosis. The common agent that causes it is the Epstein-Barr virus, which is actually a fourth type herpes virus. More than 90% of adults have experienced an infection from this "elusive" virus at some point in their lives, despite the fact that it does not appear to affect individuals frequently. The blood’s antibody levels serve as proof of this.

Roughly 45–50% of children aged 5-7 years have similar antibodies, indicating that there was an infection and immunity was developed.

The virus is particularly enjoyable to certain human body cells called lymphocytes. Under suitable favorable circumstances, such as weakened immunity, it quickly replicates there. Because the infectious mononucleosis virus is typically spread through physiological fluids like saliva, it’s commonly referred to as "kissing disease." The virus is spread by airborne droplets less frequently.

The pathogen is passed from a pregnant woman to her fetus through the general bloodstream, as well as during organ and bone marrow transplants.

There is no chronic form of infectious mononucleosis; instead, it is an acute viral illness. The virus swiftly spreads throughout the body from the afflicted lymph nodes, affecting the internal organs that contain lymphoid tissue.

Symptoms

According to Evgeny Komarovsky, infectious mononucleosis in children is mild in 90% of cases, which is why it is rarely diagnosed. Rarely do children under the age of two become ill with this disease, and most of the time the illness is mild. Boys are more likely to get sick than girls, and children three years old and up have a considerably tougher time with the illness. The reason for this is beyond the scope of medicine, but it is a known fact.

For a considerable amount of time after the mononucleosis virus enters the child’s body, the foreign agent can behave normally. Here, the baby’s immunity level determines everything. It might take a month or two if the natural defense is robust. The disease’s early symptoms could show up in as little as five to six days if the body is weak.

Evgeny Komarovsky states that enlarged lymph nodes are the first symptom. Although the nodes in the cervical, submandibular, and occipital regions increase to varying degrees, all node groups do so most. The liver and spleen, which are made of lymphoid tissue, can now be seen to have enlarged on an ultrasound. Additionally, a changed lymphocyte formula will be shown in clinical blood tests.

Immediately following this, the tonsils become inflamed and the lymphoid tissue in the nose starts to swell. The child has trouble breathing through his nose, mostly through his mouth, and he snores loudly at night. The young person may report having a sore throat.

Non-specific general symptoms can mislead medical professionals and parents.

• Lack or decrease in appetite.
• Tearfulness, capriciousness, lethargy.
• Increased body temperature.
• Pain when swallowing.
• Feeling of "aches" in the body.

When these symptoms occur all at once or in combination, they may cause concerned parents and the pediatrician to become suspicious. Blood testing is essential. Infected lymphocytes change from being lymphocytes to new cells that cannot exist in the bloodstream of a healthy child. We refer to these modified cells as atypical mononuclear. The diagnosis will be fully verified if the lab assistant discovers them in the infant’s blood. Additionally, the blood will contain more monocytes and leukocytes.

The illness itself is not even the source of danger; potential concurrent infections are. When a лимфоидная ткань поражает, израет важнейшуя роль в работе иммунитета ребенка, организм более, чем обычно, становится уязвим для различных вирусов и бактерий. This can be risky because, depending on the microbe or viral agent that has "joined," a secondary disease could develop at any time. More frequently, bacterial infections cause complications like tonsillitis, otitis media, and pneumonia.

Komarovsky about treatment

One cannot refer to the illness as quick. For some people, the acute phase lasts a little longer than two to three weeks. Naturally, the child’s health at this point will not be optimal and may even be quite serious. All children are susceptible to infectious mononucleosis, so you will need to exercise patience.

Treatment for uncomplicated mononucleosis is not necessary. All that should be given to a child who feels well is plenty of fluids. In the event that the baby’s condition is not improving, the doctor might recommend hormonal anti-inflammatory medications. Since there is no known treatment for mononucleosis, care should be limited to treating its symptoms. For example, if you have a sore throat, gargle with salt water; if your nose is blocked, apply saline solution; and moisturize your bronchi’s mucous membranes to prevent respiratory system complications.

Antiviral medications won’t affect the herpes virus type 4, but they will "hit" the parents’ pockets hard, so Komarovsky doesn’t see the point in taking them. Furthermore, everything is quite appalling given the antiviral drugs’ clinically demonstrated efficacy. Giving a child homeopathic medications with a claimed antiviral effect is pointless for the same reason. They won’t hurt you, of course, but you also shouldn’t anticipate any advantages.

The goal of treatment should be to establish the ideal environment for the child’s quick, independent recovery:

• In the acute stage of the disease, the baby needs rest, bed rest;
• The child should breathe humidified air (relative humidity in the room is 50-70%);
• It is necessary to provide plenty of warm drinks throughout the acute period;
• More often do wet cleaning in the child"s room, without using household chemicals containing chlorine;
• At high temperatures, the child can be given "Paracetamol" or "Ibuprofen".

You can and should walk outside more frequently once the temperature returns to normal. However, you should avoid going to playgrounds or other areas where large crowds of people congregate, as this will prevent the child from spreading illness to others and from "catching" another infection that could compromise his already compromised immune system.

It’s important to follow a therapeutic diet during treatment, keeping the child away from all foods that are fatty, fried, smoked, or salty, as well as foods that are spicy, sour, or sweet. It is recommended to offer vegetable soups, mashed potatoes, milk porridges, and cottage cheese to patients who are experiencing acute dysphagia. While not all food needs to be pureed during the recovery phase, the aforementioned products are still prohibited.

In the event that bacterial complications "join" mononucleosis, antibiotics are the only effective treatment for them. Parents should be aware that there is a 97% chance that their child will develop a rash if the doctor prescribes "Ampicillin" or "Amoxicillin," which are common antibiotics for pediatric patients. Medicine does not yet know why such a reaction takes place. All we can be certain of is that this rash is not going to be an antibiotic allergy, a symptom of another illness, or a consequence. It simply shows up and then vanishes on its own. This shouldn’t be terrifying.

According to Dr. Komarovsky, children with mononucleosis frequently exhibit symptoms like fever, sore throats, and enlarged lymph nodes, which can be misdiagnosed as the flu or a common cold. He underlines the significance of a correct diagnosis and the fact that, although the primary goal of treatment is to reduce symptoms, recuperation also depends on rest and supportive care. Additionally, Dr. Komarovsky counsels parents to keep a close eye on their child’s condition and see a physician to make sure the illness doesn’t worsen.

Recommendations of Dr. Komarovsky

Parents should disclose the existence of infectious mononucleosis to the preschool they send their child to or the school. However, quarantine is not necessary for this disease. It’s just that the premises will need to be wet cleaned more frequently.

After contracting infectious mononucleosis, recovery takes a while because the immune system is severely compromised. The attending pediatrician stops all of the child’s scheduled vaccinations for the following year (or sometimes even for half a year). It is not advised for children to spend a lot of time in close-knit groups. Taking the baby to the sea to "correct" his immunity is not a good idea because severe acclimatization following a viral disease is a given. It is not advised to stroll in the sun or go to areas where there is a lot of physical activity throughout the year.

The body needs age-appropriate vitamin complexes to aid in the healing process.

Following an illness, a child ought to see a doctor more frequently. Because of its oncogenic activity, the virus may play a role in the emergence of cancerous tumor disorders. The infant has to be seen and registered with a hematologist if, following an illness, the same modified mononuclear cells are detected in the child’s blood tests for an extended period of time.

After an illness, a stable lifelong immunity to the virus causing infectious mononucleosis develops. It is not possible to contract the illness again. HIV-positive individuals are the only exception, and they are capable of experiencing any number of acute illness episodes.

While mononucleosis can seem frightening, Dr. Komarovsky emphasizes that it is treatable with the right care. Being aware of the symptoms, such as fever, swollen glands, and exhaustion, aids in early diagnosis and treatment.

He counsels parents to make sure their child recovers by getting lots of rest and drinking plenty of water. While over-the-counter drugs may alleviate symptoms, it is crucial to see a physician before beginning any treatment.

Overall, most children recover completely and without complications from mononucleosis when given the proper care and medical direction.

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