Epstein barr virus symptoms treatment. Epstein Barr virus - what to do and how to be? Epstein-Barr virus drug treatment

Diet for mononucleosis

Blood analysis

The most common diseases among children are viral. The reason is that the child's immunity is still not strong enough, immature, and it is not always easy for him to withstand numerous threats from outside. But if a lot has been said and written about the flu and chickenpox, and everything is more or less clear to mothers with measles, then there are viruses in this world, the names of which alone bring sacred horror to parents.

One of these little-studied and very common is the Epstein-Barr virus. The well-known pediatrician and TV presenter Yevgeny Komarovsky is often asked about him.

What it is

EBV - Epstein Barr virus. One of the most widespread viruses on the planet. It was first found in tumor samples and described in 1964 by English professor Michael Epstein and his assistant Yvonne Barr. This is the herpes virus of the fourth type.

According to medical statistics, traces of the infection are found in the blood tests of half of children aged 5-6 years and in 97% of adults, and they themselves often do not even know about it, because in most people EBV goes unnoticed, without symptoms.

A child can become infected in different ways. Most often, EBV is excreted with body fluids, usually with saliva. For this reason, infectious mononucleosis caused by the virus is called "kissing disease".

Infection can occur during the transfusion of blood and its components, through things and toys shared with the patient, and the virus is also transmitted from an infected mother through the placenta to the fetus during pregnancy. EBV is easily spread by airborne droplets and from donor to recipient during bone marrow transplantation.

At risk are children under one year of age who are actively learning the world through the mouth, trying to try on the tooth absolutely all the objects and things that came to hand. Another “problem” age is children from 3 to 6 years old who regularly attend kindergarten and have numerous contacts.

The incubation period is from 1 to 2 months, after which the children develop vivid symptoms that are characteristic of many viral infections.

However, the virus itself with a complex name is not so terrible, but the fact that its consequences are completely unpredictable. It can go completely unnoticed in one child, while in another it will cause the development of serious conditions and even oncological diseases.

Komarovsky on VEB

Evgeny Komarovsky urges parents not to create unnecessary hysteria around the Epstein-Barr virus. He believes that most of the children with this agent have already met in early childhood, and their immunity "remembered" it and is able to identify and resist.

And now let's listen to Dr. Komarovsky about infectious monoculosis.

The symptoms that make it possible to suspect EBV in a child are rather vague:

• Irritability, tearfulness, increased moodiness and frequent causeless fatigue.
• Slight or more noticeable enlargement of the lymph nodes. Most often - submandibular and behind the ear. If the infection is severe - throughout the body.
• Lack of appetite, digestive problems.
• Rash.
• High temperature (up to 40.0).
• Sore throat (as in sore throat and pharyngitis).
• Strong sweating.
• Slight enlargement of the liver and spleen. In a child, this may be manifested by aching pains in the abdomen.
• Yellowness of the skin. This symptom is extremely rare.

Komarovsky emphasizes that on the basis of complaints alone and the presence of certain symptoms, it is impossible to make a diagnosis, since the child's condition will resemble a sore throat, enterovirus, and lymphogranulomatosis.

To confirm or refute the Epstein-Barr virus, laboratory diagnostics of the patient's blood samples is required, including biochemical analysis, serological testing, PCR, and it is also desirable to make an immunogram and conduct an ultrasound examination of the abdominal organs - the liver and spleen.

Komarovsky often compares VEB with chickenpox. Both diseases are more easily tolerated at an early age, the younger the person, the simpler the disease and the fewer consequences. The older the primary infection occurs, the greater the chances of severe complications.

Treatment according to Komarovsky

Evgeny Olegovich warns that the treatment with antibiotics of the penicillin group of one of the diseases associated with EBV - infectious mononucleosis can cause serious complications. Usually such an appointment is erroneous when the doctor takes mononucleosis for the usual bacterial tonsillitis. In this case, exanthema may develop.

Ordinary children who do not suffer from HIV and other severe disorders of the immune system, according to Yevgeny Komarovsky, do not need any antiviral treatment for mononucleosis caused by EBV, and even more so, they do not need to be urgently given immunostimulants. A well-known pediatrician is sure that the child's body is able to cope with this threat on its own.

If the course of the disease is severe, which, according to Komarovsky, is very rare, treatment in a hospital may be required. There, most likely, antiherpetic drugs will be used (quite justifiably).

In all other cases, symptomatic treatment is sufficient. It includes antipyretics (if the temperature is above 38.5-39.0), remedies that reduce sore throats (lozenges, antiseptics, rinses), ointments, gels and external antiseptic sprays for severe skin rashes.

Epstein-Barr virus (EBV). Symptoms, diagnosis, treatment in children and adults

Thank you

The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Epstein-Barr virus is a virus that belongs to the herpes family of viruses, the 4th type of herpes infection, is capable of infecting lymphocytes and other immune cells, mucous membrane of the upper respiratory tract, neurons of the central nervous system and almost all internal organs. In the literature, you can find the abbreviation VEB or VEB - infection.

Possible abnormalities in liver function tests in infectious mononucleosis:

1. 
   Increased transaminase levels several times:
   • ALT norm 10-40 IU/l,
   
   
   • AST norm 20-40 IU / l.
   
   
2. Increase in thymol test - the norm is up to 5 units.


3. Moderate increase in total bilirubin due to unbound or direct: the norm of total bilirubin is up to 20 mmol / l.


4. Increased alkaline phosphatase - the norm is 30-90 IU / l.

A progressive increase in indicators and an increase in jaundice may indicate the development of toxic hepatitis, as a complication of infectious mononucleosis. This condition requires intensive care.

Epstein-Barr virus treatment

It is impossible to completely overcome herpetic viruses, even with the very modern treatment Epstein-Barr virus remains in B-lymphocytes and other cells for life, although not in an active state. When immunity is weakened, the virus can become active again, exacerbating EBV infection occurs.

There is still no common opinion among physicians and scientists regarding the methods of treatment, and a a large number of research on antiviral treatment. On this moment There are no specific drugs effective against the Epstein-Barr virus.

Infectious mononucleosis is an indication for inpatient treatment, with further recovery at home. Although with a mild course, hospitalization in the hospital can be avoided.

In the acute period of infectious mononucleosis, it is important to observe sparing regimen and diet:

• semi-bed rest, restriction of physical activity,


• need to drink plenty of water


• meals should be frequent, balanced, in small portions,


• exclude fried, spicy, smoked, salty, sweet foods,


• fermented milk products have a good effect on the course of the disease,


• the diet should contain a sufficient amount of proteins and vitamins, especially C, group B,


• refuse products containing chemical preservatives, dyes, flavor enhancers,


• it is important to exclude foods that are allergens: chocolate, citrus fruits, legumes, honey, some berries, out-of-season fresh fruits, and others.

For chronic fatigue syndrome useful will be:

• normalization of the mode of work, sleep and rest,


• positive emotions, doing what you love,


• complete nutrition,


• multivitamin complex.

Epstein-Barr virus drug treatment

Drug treatment should be comprehensive, aimed at immunity, elimination of symptoms, alleviation of the course of the disease, prevention of development possible complications and their treatment.

The principles of treatment of EBV infection in children and adults are the same, the difference is only in the recommended age dosages.

Drug group	A drug	When is it appointed?
Antiviral drugs that inhibit the activity of Epstein-Barr virus DNA polymerase	acyclovir, Gerpevir, Paciclovir, cidofovir, Foscavir	In acute infectious mononucleosis, the use of these drugs does not give the expected result, which is associated with the peculiarity of the structure and vital activity of the virus. But with generalized EBV infection, oncological diseases associated with the Epstein-Barr virus and other manifestations of the complicated and chronic course of the Epstein-Barr virus infection, the appointment of these drugs is justified and improves the prognosis of diseases.
Other drugs with non-specific antiviral and / or immunostimulatory effects	Interferon, Viferon, Laferobion, Cycloferon, Isoprinazine (Groprinazine), Arbidol , Uracil, rimantadine, Polyoxidonium, IRS-19 and others.	Also, they are not effective in the acute period of infectious mononucleosis. They are prescribed only in case of a severe course of the disease. These drugs are recommended during exacerbations of the chronic course of EBV infection, as well as during the recovery period after acute infectious mononucleosis.
Immunoglobulins	pentaglobin, Polygamy Sandlglobulin, Bioven and others.	These drugs contain ready-made antibodies against various infectious pathogens, bind to Epstein-Barr virions and remove them from the body. Their high efficiency in the treatment of acute and exacerbation of chronic Epstein-Barr virus infection has been proven. They are used only in a stationary clinic in the form of intravenous droppers.
Antibacterial drugs	Azithromycin, Lincomycin, Ceftriaxone, Cefadox and others	Antibiotics are prescribed only if a bacterial infection is attached, for example, with purulent tonsillitis, bacterial pneumonia. Important! In infectious mononucleosis, penicillin antibiotics are not used: benzylpenicillin,
vitamins	Vitrum , Pikovit, Neurovitan, Milgama and many others	Vitamins are necessary in the recovery period after infectious mononucleosis, as well as in chronic fatigue syndrome (especially B vitamins), and to prevent exacerbation of EBV infection.
Antiallergic (antihistamine) drugs	Suprastin, Loratadine (Claritin) Tsetrin and many others.	Antihistamines are effective in the acute period of infectious mononucleosis, alleviate the general condition, reduce the risk of complications.
Non-steroidal anti-inflammatory drugs	paracetamol, ibuprofen, Nimesulide and others	These drugs are used for severe intoxication, fever. Important! Do not use aspirin.
Glucocorticosteroids	prednisolone, Dexamethasone	Hormonal drugs are used only in severe and complicated cases of the Epstein-Barr virus.
Preparations for the treatment of the throat and oral cavity	Ingalipt, Lisobakt, Decatilen and many others.	This is necessary for the treatment and prevention of bacterial tonsillitis, which often joins against the background of infectious mononucleosis.
Preparations to improve liver function	Gepabene, Essentiale, Heptral , Karsil and many others.	Hepatoprotectors are necessary in the presence of toxic hepatitis and jaundice, which develops against the background of infectious mononucleosis.
Sorbents	Enterosgel , Atoxil, activated carbon and others.	Intestinal sorbents promote faster elimination of toxins from the body, facilitate the acute period of infectious mononucleosis.

Treatment of the Epstein-Barr virus is selected individually depending on the severity of the course, the manifestations of the disease, the state of the patient's immunity and the presence of concomitant pathologies.

Principles of drug treatment of chronic fatigue syndrome

• Antiviral drugs: Acyclovir, Gerpevir, Interferons,


• vascular drugs: Actovegin, Cerebrolysin,


• drugs that protect nerve cells from the effects of the virus: Glycine, Encephabol, Instenon,



• sedatives,


• multivitamins.

Epstein-Barr virus treatment with folk remedies

Alternative methods of treatment will effectively complement drug therapy. Nature has a large arsenal of drugs to boost immunity, which is so necessary to control the Epstein-Barr virus.

1. Echinacea tincture - 3-5 drops (for children over 12 years old) and 20-30 drops for adults 2-3 times a day before meals.


2. Ginseng tincture - 5-10 drops 2 times a day.


3. herbal collection (not recommended for pregnant women and children under 12):
   
   
   • Chamomile flowers,
   
   
   • Peppermint,
   
   
   • Ginseng,
   
   
   
   • Marigold flowers.
   Take herbs in equal proportions, stir. To brew tea, 1 tablespoon is poured into 200.0 ml of boiling water and brewed for 10-15 minutes. Taken 3 times a day.


4. Green tea with lemon, honey and ginger - increases the body's defenses.


5. fir oil - used externally, lubricate the skin over enlarged lymph nodes.


6. Raw egg yolk: every morning on an empty stomach for 2-3 weeks, improves liver function and contains a large amount of nutrients.


7. Magonia Root or Oregon Grape Berries - add to tea, drink 3 times a day.

Which doctor should I contact with the Epstein-Barr virus?

If infection with the virus leads to the development of infectious mononucleosis ( heat, pain and redness in the throat, signs of sore throat, joint pain, headaches, runny nose, enlarged cervical, submandibular, occipital, supraclavicular and subclavian, axillary lymph nodes, enlarged liver and spleen, abdominal pain
So, with frequent stress, insomnia, causeless fear, anxiety, it is best to contact a psychologist. If mental activity worsens (forgetfulness, inattention, poor memory and concentration, etc.), it is best to contact a neurologist. With frequent colds, exacerbations of chronic diseases or relapses of previously cured pathologies, it is best to contact an immunologist. And you can contact a general practitioner if a person is worried various symptoms, and none of them are the most pronounced.

If infectious mononucleosis becomes a generalized infection, you should immediately call an ambulance and be hospitalized in the intensive care unit (reanimation).

FAQ

How does the Epstein-Barr virus affect pregnancy?

When planning a pregnancy, it is very important to prepare and go through all the necessary studies, as there are a lot of infectious diseases that affect conception, pregnancy and the health of the baby. Such an infection is the Epstein-Barr virus, which belongs to the so-called TORCH infections. The same analysis is suggested to be taken during pregnancy at least twice (12th and 30th week).

Pregnancy planning and testing for antibodies to the Epstein-Barr virus:

• Class immunoglobulins discovered G( VCA And EBNA) - you can easily plan a pregnancy, with good immunity, the reactivation of the virus is not terrible.


• Positive immunoglobulins class M - with the conception of a baby, you will have to wait until complete recovery, confirmed by an analysis for antibodies to EBV.


• There are no antibodies to the Epstein-Barr virus in the blood - it is possible and necessary to become pregnant, but you will have to be observed, periodically taking tests. You also need to protect yourself from possible infection with EBV during the gestation period, strengthen your immunity.

If class M antibodies are detected during pregnancy to the Epstein-Barr virus, then the woman must be hospitalized in a hospital until complete recovery, the necessary symptomatic treatment is carried out, antiviral drugs are prescribed, and immunoglobulins are administered.

How exactly the Epstein-Barr virus affects pregnancy and the fetus is not yet fully understood. But many studies have shown that pregnant women with active EBV infection are much more likely to have pathologies in the child they are carrying. But this does not mean at all that if a woman had an active Epstein-Barr virus during pregnancy, then the child should be born unhealthy.

Possible complications of the Epstein-Barr virus on pregnancy and fetus:

• premature pregnancy (miscarriage),


• stillbirth,


• intrauterine growth retardation (IUGR), fetal hypotrophy,


• prematurity,


• postpartum complications: uterine bleeding, DIC, sepsis,


• possible malformations of the central nervous system of the child (hydrocephalus, underdevelopment of the brain, etc.) associated with the action of the virus on the nerve cells of the fetus.

Can the Epstein-Barr virus be chronic?

Epstein-Barr virus - like all herpes viruses, it is a chronic infection that has its own flow periods:

1. Infection followed by an active period of the virus (acute viral EBV infection or infectious mononucleosis);


2. Recovery, in which the virus goes into an inactive state , in this form, the infection can exist in the body for life;


3. Chronic viral infection Epstein-Barr - characterized by reactivation of the virus, which occurs during periods of reduced immunity, manifests itself in the form various diseases(chronic fatigue syndrome, changes in immunity, cancer, and so on).

What are the symptoms of the Epstein-Barr igg virus?

To understand the symptoms Epstein-Barr igg virus , it is necessary to understand what is meant by the data symbol. letter combination igg is a variant of the misspelling of IgG, which is used for brevity by doctors and laboratory workers. IgG is immunoglobulin G, which is a variant of antibodies produced in response to entry virus into the body in order to destroy it. Immunocompetent cells produce five types of antibodies - IgG, IgM, IgA, IgD, IgE. Therefore, when they write IgG, they mean antibodies of this particular type.

Thus, the entire record "Epstein-Barr virus igg" means that we are talking about the presence in the human body of antibodies of the IgG type to the virus. Currently, the human body can produce several types of IgG antibodies to different parts of the body. Epstein-Barr virus, such as:

• IgG to the capsid antigen (VCA) – anti-IgG-VCA;
• IgG to early antigens (EA) - anti-IgG-EA;
• IgG to nuclear antigens (EBNA) - anti-IgG-NA.

Each type of antibody is produced at certain intervals and stages of the infection. Thus, anti-IgG-VCA and anti-IgG-NA are produced in response to the initial penetration of the virus into the body, and then persist throughout life, protecting a person from re-infection. If anti-IgG-NA or anti-IgG-VCA are found in a person's blood, then this indicates that he was once infected with the virus. And the Epstein-Barr virus, once it enters the body, remains in it for life. Moreover, in most cases, such a virus carrier is asymptomatic and harmless to humans. In more rare cases, the virus can lead to a chronic infection known as chronic fatigue syndrome. Sometimes, during a primary infection, a person develops infectious mononucleosis, which almost always ends in recovery. However, with any variant of the course of infection caused by the Epstein-Barr virus, anti-IgG-NA or anti-IgG-VCA antibodies are found in a person, which are formed at the time of the first penetration of the microbe into the body in life. Therefore, the presence of these antibodies does not allow us to accurately speak about the symptoms caused by the virus at the current time.

But the detection of antibodies such as anti-IgG-EA may indicate an active course of a chronic infection, which is accompanied by clinical symptoms. Thus, under the entry "Epstein-Barr igg virus" in relation to symptoms, doctors understand precisely the presence in the body of antibodies of the anti-IgG-EA type. That is, we can say that the concept of "Epstein-Barr igg virus" in short form indicates that a person has symptoms of a chronic infection caused by a microorganism.

Symptoms of a chronic Epstein-Barr virus infection (EBSI, or chronic fatigue syndrome) are as follows:

• Prolonged low-grade fever;
• Low performance;
• Causeless and inexplicable weakness;
• Enlarged lymph nodeslocated in various parts of the body;
• sleep disorders;
• Recurrent angina.

Chronic VEBI proceeds in waves and for a long time, and many patients describe their condition as a "permanent flu". The severity of symptoms of chronic EBV can alternately vary from severe to mild. Currently, chronic VEBI is called chronic fatigue syndrome.

In addition, chronic EBV can lead to the formation of some tumors, such as:

• Nasopharyngeal carcinoma;
• Burkitt's lymphoma;
• Neoplasms of the stomach and intestines;
• Hairy leukoplakia of the mouth;
• Thymoma (tumor of the thymus), etc.

Before use, you should consult with a specialist.

Epstein-Barr herpes virus is a common infection that does not have a specific method of prevention. EBV affects B-lymphocytes, which causes their uncontrolled reproduction, contributes to the formation of autoimmune diseases, tumor growth of lymphoid tissue.

Epstein-Barr virus was isolated in 1964 from Burkitt's lymphoma, a malignant tumor caused by impaired cell division and maturation of B-lymphocytes. Epstein-Barr virus (EBV or EBV infection) is a low-contagious disease, such a disease does not cause epidemics, due to the fact that 55-60% of children and 90% of adults have antibodies to it.

The disease is named after the scientists who isolated the virus. Other recognized international name Epstein-Barr infections - infectious mononucleosis.

EBV belongs to the DNA-containing herpesviruses Herpesviridae, carries 4 types of antigens (protein receptors), due to which it exhibits pathogenic activity. According to antigens (AG), the Epstein-Barr virus does not differ from herpes simplex.

Specific antigens are used to diagnose the Epstein-Barr virus by analyzing blood and saliva. You can read about the methods for recognizing the Epstein-Barr virus, tests for EBV infection, symptoms and its treatment in children and adults on the website.

There are 2 strains of the Epstein-Barr virus:

• strain A is found everywhere in the world, but in Europe, the USA is more often manifested in the form of infectious mononucleosis;
• strain B - in Africa manifests itself as Burkitt's lymphoma, in Asia - as nasopharyngeal carcinoma.

What tissues are affected by the virus

Epstein-Barr virus has tropism (the ability to interact) to:

• lymphoid tissues - causes an increase in lymph nodes, liver, spleen;
• B-lymphocytes - multiplies in B-lymphocytes, without destroying them, but accumulating inside the cells;
• epithelium of the respiratory tract;
• epithelium of the digestive tract.

The uniqueness of the Epstein-Barr virus is that it does not destroy infected cells (B-lymphocytes), but provokes their reproduction and growth (proliferation) in the body.

Another feature of EBV is the ability to exist for life in infected cells. This process is called persistence.

Methods of infection

Epstein-Barr virus refers to anthroponotic infections, transmitted through people. EBV is often found in the saliva of people with immunodeficiencies, such as those with HIV.

Epstein-Barr virus survives in a humid environment, which makes it easier to enter the body, it is transmitted, like herpes:

• airborne way;
• tactile through the hands, saliva when kissing;
• during blood transfusion;
• transplacental way - infection in the fetus from a woman occurs in utero, and the child is already born with symptoms of the Epstein-Barr virus.

EBV dies when heated, dried, treated with antiseptics. Infection occurs in childhood in children from 2 to 10 years old. The second peak of Epstein-Barr infection occurs at the age of 20-30 years.

There are especially many infected in developing countries, where by the age of 3 all children are infected. The disease lasts 2-4 weeks. Acute symptoms Epstein-Barr virus infections appear in the first 2 weeks.

Mechanism of infection

Epstein-Barr virus infection enters the body through the nasopharyngeal mucosa, affects B-lymphocytes in the lymph nodes, causing the first clinical symptoms in adults and children.

After 5 - 43 days of the incubation period, infected B-lymphocytes enter the bloodstream, from where they spread throughout the body. The duration of the incubation period of the Epstein-Barr virus is on average 7 days.

In in vitro (in vitro) experiments, B-lymphocytes infected with EBV infection are characterized by "immortality". They acquire the ability to multiply by division indefinitely.

It is assumed that this property underlies malignant changes in the body during EBV infection.

The immune system counteracts the spread of infected B-lymphocytes with the help of another group of lymphocytes - T-killers. These cells respond to the viral antigen that appears on the surface of the infected B-lymphocyte.

Natural killer NK cells are also activated. These cells destroy infected B-lymphocytes, after which EBV becomes available for inactivation by antibodies.

After recovery, immunity to infection is created. Antibodies in EBV are found throughout life.

Symptoms

The outcome of EBV infection depends on the state of the human immune system. Symptoms of infection with the Epstein-Barr virus in adults may be manifested only by moderate activity of liver enzymes and do not require treatment.

Epstein-Barr virus infection can occur with erased symptoms, manifested by an increase in the cervical lymph nodes, as in the photo. But with a decrease in the immune reactivity of the body, especially with insufficient activity of T-lymphocytes, infectious mononucleosis of varying severity may develop.

Infectious mononucleosis

Infection with the Epstein-Barr virus occurs in a mild, moderate, severe form. With an atypical form, the disease can be asymptomatic in a latent (latent) form, recurring with a decrease in immune reactivity.

In children younger age the disease proceeds, as it begins acutely. Adults are characterized by a less acute onset when infected with the Epstein-Barr virus, the gradual development of symptoms.

The following forms of the virus are distinguished by the nature of the course:

• sharp;
• protracted;
• chronic.

Epstein-Barr infection is detected at a young age. In manifestations, it resembles, accompanied by severe swelling of the tonsils.

Purulent follicular tonsillitis with a dense coating on the tonsils may develop. See what a sore throat looks like in the photo in the article What does a sore throat look like in adults and children.

Nasal congestion and eyelid edema are characteristic of EBV.

The first symptoms of infection with the Epstein-Barr virus are signs of intoxication:

• headache, muscle pain;
• lack of appetite;
• sometimes nausea;
• weakness.

Symptoms of infection develop within a week. A sore throat appears and intensifies, the temperature rises to 39 degrees. An increase in temperature is observed in 90% of patients, but, unlike ARVI, the rise in temperature is not accompanied by chills or increased sweating.

A high temperature can last for more than a month, but more often lasts from 2 days to 3 weeks. After recovery may long time(up to six months) subfebrile temperature persists.

Characteristic features

Typical manifestations of infection are:

• enlarged lymph nodes - first, the tonsils of the pharyngeal ring, cervical lymph nodes increase, then - axillary, inguinal, mesenteric;
• angina - the virus affects the respiratory tract in this area;
• skin rash caused by allergic reactions;
• joint pain due to the action of immune complexes that arise in response to the introduction of viruses;
• abdominal pain caused by enlarged mesenteric lymph nodes.

One of the most typical symptoms is a symmetrical enlargement of the lymph nodes, which:

• reach the size of a pea or walnut;
• freely displaced under the skin, not soldered to it;
• dense to the touch;
• do not suppurate;
• do not get drunk among themselves;
• slightly painful, surrounding tissues may be edematous.

The size of the lymph nodes decreases after 3 weeks, but sometimes they remain enlarged for a long time.

Typically for infection, the appearance of pain occurs due to enlarged tonsils, which are hyperemic, covered with a white coating.

Not only the tonsils become inflamed, but also other tonsils of the pharyngeal ring, including, because of which the voice becomes nasal.

• Epstein-Barr infection is characterized by an increase in the size of the liver by 2 weeks, the appearance of icteric coloration of the skin. The size of the liver is normalized after 3-5 weeks.
• The spleen also increases, and even to a greater extent than the liver, but after 3 weeks of illness, its size returns to normal.

Infection with Epstein-Barr viruses is often accompanied by signs of allergy. In a quarter of patients, infection is manifested by the appearance of a rash, Quincke's edema.

Chronic form of infectious mononucleosis

Chronic infection with EBV leads to immunodeficiency, due to which a fungal or bacterial infection joins the viral infection.

The patient constantly experiences:

• headache;
• discomfort in muscles and joints;
• seizures;
• weakness;
• mental disorders, memory impairment;
• depression
• constant feeling of fatigue.

Signs of Burkitt's lymphoma

A malignant disease Burkitt's lymphoma often develops in children from 3 to 7 years old, young men, is a tumor of the lymph nodes upper jaw, small intestine, abdominal cavity. The disease often occurs in individuals who have had mononucleosis.

To establish the diagnosis, a biopsy of the affected tissues is performed. In the treatment of Burkitt's lymphoma use:

• chemotherapy;
• antiviral drugs;
• immunomodulators.

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma is more common in men aged 30-50 years, the disease is common in China. The disease is manifested by a sore throat, a change in the timbre of the voice.

Carcinoma is treated with surgery, during which enlarged lymph nodes are removed. The operation is combined with chemotherapy.

Treatment

Treatment is aimed at increasing immune reactivity, for which Isoprinosine, Viferon, alpha-interferon are used. Against the virus, drugs are used that stimulate the production of interferon in the body:

• Neovir - from birth;
• Anaferon - from 3 years;
• Cycloferon - from 4 years;
• Amiksin - after 7 years.

The activity of the virus inside the cells is suppressed by drugs from the group of abnormal nucleotides, such as Valtrex, Famvir, Cymeven.

To increase immunity appoint:

• immunoglobulins, interferons - Intraglobin, Reaferon;
• immunomodulators - Timogen, Likopid,;
• cytokines - Leukinferon.

In addition to specific antiviral and immunomodulatory treatment, Epstein-Barr virus uses:

• antihistamines - Fenkarol, Tavegil, Zirtek;
• glucocorticosteroids in severe disease;
• antibiotics for angina of the macrolide group, such as Sumamed, Erythromycin, a group of tetracyclines, Cefazolin;
• probiotics - Bifiform, Probiform;
• hepatoprotectors for maintaining the liver - Essentiale, Gepabene, Karsil, Ursosan.

For fever, cough, nasal congestion and other symptoms of Epstein-Barr virus infection, treatment is prescribed, including antipyretics,.

Despite the variety of drugs, a unified scheme for how and how to treat infectious mononucleosis in adults and children with infection with the Epstein-Barr virus has not been developed.

Clinical forms of the Epstein-Barr virus

After recovery, patients are on dispensary records for six months. Once every 3 months, donate blood and oropharyngeal mucus to the EBV.

The disease rarely causes complications. But in severe forms of EBV, the infection passes into a persistent state, and can manifest itself:

• Hodgkin's lymphoma - cancer of the lymph nodes;
• systemic hepatitis;
• autoimmune diseases - multiple sclerosis, systemic lupus erythematosus;
• tumors salivary glands, intestines, leukoplakia of the tongue;
• lymphocytic pneumonia;
• chronic fatigue syndrome.

Forecast

The prognosis for infection with Epstein-Barr viruses is favorable. Complications leading to death are extremely rare.

The danger is virus. Under adverse conditions, which, among other things, may be associated with a decrease in immunity, they can cause relapses of chronic infectious mononucleosis, manifest themselves in various malignant forms of Epstein-Barr infection.

Epstein-Barr virus is a highly virulent strain of a herpes agent (herpes type 4). According to medical statistics, almost all people on the planet are carriers of this virus. Carriage is not always accompanied by obvious symptoms. The Epstein-Barr agent causes the occurrence of a number of diseases. What should you know about such an insidious adversary and methods of treating the Epstein-Barr virus?

Brief information

• The classic disease caused by herpes type 4 is infectious mononucleosis.. Develops in the vast majority of cases.
• A large role of the virus in the formation of the most malignant and aggressive tumor - glioblastoma (brain cancer) has been proven.
• The agent is able to provoke an increase in the proliferative activity of the upper respiratory tract (pharynx, larynx).
• Severe lesions of the gastrointestinal tract - gastritis, ulcers, hepatitis.
• EBV provokes tumors of the lymphatic system.

Fatigue, weakness, constant weakness can be caused by the specified viral agent. The condition is known as chronic fatigue syndrome.

Despite such a wide list of probable diseases, typical mononucleosis develops in 90% of cases.

Causes of infection

The infection is highly contagious. In practice, this means that infection occurs in various ways and regardless of the state of immunity of a potential carrier. There are several ways for EBV to enter the body:

• Contact. Handshakes, kisses, that is, interaction with the mucous membranes and dermal cover of the infected person is the most common route of infection.
• Airborne. With cough, saliva and other bodily fluids, the agent is released into environment and enters organisms.

The immediate causes can be identified as follows:

• Contact with a sick person.
• Interaction with the body fluids of an infected person (first of all, medical workers are at risk).
• Unprotected sex. Adults can get EBV as a result of promiscuity.
• Use of household items of a sick person.

Infection can also be congenital. In this case, the agent enters the child's body when it passes through the birth canal. There is a high chance of becoming a carrier through a blood transfusion.

Typical symptoms

Symptoms are mostly defined in the context of the most common disease caused by EBV: infectious mononucleosis. In the acute phase, the disease is manifested by the following symptoms:

• General intoxication. This is the prodromal period of the formation of pathology. The process begins in the second or third week and manifests itself non-specifically. At the end of the incubation period, primary symptoms of a general nature are formed. It is extremely difficult to distinguish mononucleosis from a simple cold at this stage, the signs are almost identical.
• After 3-5 days, a typical picture begins to take shape. infection. Complex lymphadenitis develops. All lymph nodes become inflamed, including inguinal, submandibular. The acute phase of lymphadenitis lasts about 14 days and resolves on its own. In some cases, the formation of complications is possible - abscesses and suppuration of the nodes.
• Rash. Another pathognomonic sign. The whole body is covered with red papules filled with transparent exudate. When combing, herpes is mechanically transferred to healthy skin and mucous membranes, causing further infection. The rash may appear as pinpoint hemorrhages.
• Enlargement of the spleen - causes pain in the side when breathing.
• Enlargement of the liver. It provokes a number of consequences: pain in the right hypochondrium, nausea, vomiting, a change in the nature of the stool (it becomes colorless, liquid in consistency). With excessive enlargement of the liver, the onset of secondary jaundice is possible.
• Herpetic angina. Sore throat, difficulty breathing, white rashes in the area of ​​the pharyngeal ring are constant companions of the pathology.
• In severe cases, the virus can infect cerebral structures. Meningitis starts.

Acute mononucleosis lasts approximately 1-2 months and often resolves on its own without medical care . However, in this case, the risk of adverse consequences for the patient's body increases. An uncorrected state leads to increased activity of the virus. When exposed to healthy tissues, EBV increases the proliferative activity of cytological units, causing manifestations of nuclear atypia of cells. This is a direct path to neoplastic processes.

The disease can proceed in a chronic form. In this case, the symptoms are scarce or absent.

Diagnostic measures

Diagnosis involves contacting an otolaryngologist. Additionally, consultation with an infectious disease specialist is required. The doctor interviews the patient about complaints and their nature. Gathers anamnesis of life. However, it is almost impossible to establish the moment of infection. Visual assessment of the nasopharynx plays an important role. Specialized studies should confirm the presence of a herpes lesion:

• General blood test. Demonstrates a classic picture of inflammation with an increase in the number of leukocytes, monocytes. ESR is growing.
• Biochemistry of venous blood. Increased indicators of alkaline phosphatase, bilirubin, specific substances indicating liver pathology.
• PCR and ELISA. Designed to detect the presence of virus DNA in the patient's body.
• immune analyses. Necessary to determine the presence of specific antibodies in the blood.

To exclude pathological changes in the abdominal organs, the appointment of radiography, ultrasound examination of the peritoneal organs is indicated.

Treatment

Treating the Epstein-Barr virus is an impossible task. Therapy can be chosen so that the pathogen subsides, and the disease goes into remission, but it is impossible to completely cure the disease and get rid of the pathological agent. But even this task is not easy.

Treatment for acute mononucleosis is exclusively stationary in the conditions of the infectious diseases department.

The following drugs are indicated:

• Antiviral antiherpetic drugs - fight the pathogen. The use of Acyclovir, Valaciclovir, Valtrex (analogous to Valaciclovir), Zovirax is shown. These drugs have a selective effect on EBV DNA, reduce the proliferative activity of cells, preventing the development of complications.
• Antibiotics - these drugs resist secondary infection.
• Immunomodulators - normalize the functioning of the immune system, contributing to the synthesis of interferon. Viferon, Cycloferon and other drugs.
• In the presence of hyperthermia, antipyretic drugs based on paracetamol or ibuprofen are indicated.

Treatment must be comprehensive. The treatment regimen is selected by the attending physician, as well as the number of tablets per day. The duration of the course is about 2-3 months.

It is possible to conduct additional treatment with folk remedies. In no case can it replace traditional therapy, but it is quite capable of becoming a good help. Phytotherapy is designed to relieve symptoms. You can resort to two methods:

1. The use of propolis. Alcohol tincture is prepared as follows: cool and grind 100 grams of raw materials. Pour in water and leave for 2-3 hours. Pour the infusion into a container, add 250 ml of medical alcohol or vodka. Let it brew for two weeks. Use half a teaspoon twice a day. Thus, EBV is treated until the condition improves.
2. Echinacea intake. An effective herb to combat herpes and its manifestations. It is better to use a ready-made product sold in a pharmacy.

Methods of therapy in children and adults are the same. Only the scheme of taking the drugs, which the doctor approves, differs.

Prevention

There are no specific recommendations for the prevention of infection with the Epstein-Barr virus. It is enough to keep the immune system in good shape, eat right and follow the rules of personal hygiene in order to never encounter manifestations of mononucleosis and minimize the risks of developing other associated pathologies.

VEB is an insidious enemy human body. No one can predict in advance how the agent will behave in the next moment: it is possible to exist in a latent form throughout life. It is impossible to recover from it, but in the hands of a person to prevent an increase in the activity of the body. If suddenly the virus has made itself felt, it is urgent to contact an infectious disease specialist to prescribe specific therapy.

Epstein-Barr virus infection (EBVI) is the most common infection in the world, as evidenced by the high level of Epstein-Barr virus (EBV) infection in the population. According to WHO, infection varies within 75% -90% of the entire population of the planet, including children. Like other herpes viruses, EBV persists for life in immunocytes, causing a manifest form of the disease or a latent infection.

EBVI is an acute/chronic infectious disease caused by the EB virus, which is based on damage to the lymphoreticular and immune systems of the body. EBV is the etiological agent of a number of infections. The most common manifest form of primary EBVI is Infectious mononucleosis (IM), found in the literature as Epstein Barr's disease , less often Filatov's disease or Filatov's symptom . It is also an etiological factor nasopharyngeal carcinoma , Burkitt's lymphomas , lymphoproliferative syndrome associated with the X chromosome, autoimmune diseases. Another clinical manifestation of EBV infection is chronic fatigue syndrome . The pathogenetic role of EBVI in lymphomatoid granulomatosis, peripheral T cell lymphoma , angioimmunoblastic lymphadenopathy , and in immunocompromised individuals - lymphoma central nervous system.

Often, Epstein-Barr virus infection can occur in the form of an unverified acute respiratory infection, various EBV-associated pathological conditions or generally asymptomatic. EBVI is one of the most common infectious diseases in children. Long-term replication of EBV contributes to a high infectious morbidity in children and their transition to the group of frequently/long-term ill children and is accompanied by a violation of the normal development of the child's body, a decrease in the quality of life of the child.

Pathogenesis

The entry gate for the EB virus is the mucosal epithelium of the upper respiratory tract. Penetrating through the intact layers of the mucosa, the virus is adsorbed on the cells of the epithelium of the nasopharyngeal mucosa, thymus, epithelium of the tubules of the salivary glands and infects IN- And T-lymphocytes , neutrophils , natural macrophages , endotheliocytes . The number of affected cells after infection begins to increase through uncontrolled virus-dependent cell proliferation and the virus spreads through the lymphoid tissues and peripheral blood throughout the body.

In cells infected with a virus, two types of its reproduction can occur: lytic - productive (leading to lysis of the host cell, i.e., to death) and latent, when the cell is not destroyed, and the persistence of EBV in the epithelial cells of the salivary glands, the mucosa of the nasopharyngeal region and transformed B-lymphocytes leads to the constant carriage of the virus. In the active form (acute infection), predominantly lytic replication of the virus is observed, which is accompanied by the production of viral glycoproteins and is manifested by manifest forms of the disease.

Infection with EBV leads to a weakening of the activity of innate resistance factors (inhibition of the T-cell link) and contributes to the formation of an inadequate immune response mechanism predominantly by the cellular type (a disorder in the mechanism of regulation of the immune response by T-helper types 1 and 2). In conditions of insufficiency / absence of a specific immune response - against the background of suppression of the production of interferon and the production of immunoglobulins, the body does not completely suppress the process of EBV replication, and under the influence of immunosuppressive factors (addition of mixed infection) the pathogen is reactivated.

It is the immune status disorders that are the main pathogenetic background that contributes to the long-term persistence of EBV in tissue cells. EBV in the process of chronic persistence in the cells of the immune system and epithelium independently implements complex mechanisms of immunosuppression, which does not allow the body's immune system to control the infectious process.

Classification

There are several different clinical forms of EBVI:

• chronic active EBV infection;
• nasopharyngeal carcinoma ;
• X-linked lymphoproliferative disease: malignant lymphomas , acquired hypogammaglobulinemia ;
• Burkitt's lymphoma ;
• lymphoproliferative disease: B-cell lymphoma , plasmatic hyperplasia ;
• Hodgkin's disease ;
• immunoblastic lymphoma .

According to the occurrence, congenital and acquired EBV infection is distinguished.

Along the course: acute (lasting up to 3 months), protracted (3-6 months) and chronic (6 or more months).

In form: typical (infectious mononucleosis), atypical (asymptomatic, erased, visceral).

Severity: light, medium and heavy.

Causes

The etiological factor of Epstein-Barr virus infection, as already mentioned, is the Epstein-Barr virus. First, consider the question: "Epstein Barr virus - what is it"?

EBV is one of the members of the herpes virus family and belongs to the fourth type of herpes viruses (HHV-4). Able to persist in the human body for life. It has an oncogenic and opportunistic effect. Being a lymphotropic agent, it causes diseases of the immune system, the leading syndromes of which are lymphoproliferation and immune deficiency.

The DNA of the herpes virus is represented by a double-stranded molecule. The HHV-4 virion surrounds the viral nucleic acid, together with which forms a protein icosahedral capsid with 25 faces. The diameter of the virus is 120-150 nm., general form virus is shown in the figure below. The outer shell of the virus (supercapsid) has glycoprotein spikes that act as the receptor apparatus of the virus.

Epstein-Barr virus

The outer shell of the virus (supercapsid) has glycoprotein spikes that act as the receptor apparatus of the virus. The virus has a complex antigenic structure, including several groups of immunogenic proteins (antigens) - early, capsid, nuclear and membrane antigens.

Antigenic structure of EBV:

• VEA virus early antigen;
• VCA virus capsid antigen;
• VNA virus nucleolar antigen;
• VMA virus membrane antigen.

Epidemiology

The Epstein-Barr virus has a global distribution. The source of diseases is a carrier or a sick person. Transmission factors of the virus can be saliva, blood, vaginal secretions, semen, tears, donor tissues, breast milk, toys/household items contaminated with contaminated saliva. Isolation of the virus occurs throughout the entire period of the disease and after recovery (up to 6 months).

The virus is also found in healthy individuals (in 15-25%) in swabs from the oropharynx and saliva. At the same time, with a decrease in immunity, the frequency of VB isolation increases sharply. The susceptibility of the population to the EB virus is high. After infection with a virus, synthesis of virus proteins begins after 2 hours, and within 8 hours it accumulates in the maximum amount and virions with infectious properties appear. Virus during external environment extremely unstable, dies under the influence of UV rays, disinfectants and drying of saliva drops.

The leading route of transmission of the virus is airborne (through kissing, talking, sneezing, coughing), less often - by the alimentary route (through food / water), contact-household (through household items-utensils), sexually, vertically (from mother to fetus) and by blood contact (during blood transfusion). The entrance gate is the epithelium of the nasopharyngeal mucosa. After primary infection, the virus remains in the epithelium of the nasopharyngeal mucosa, tonsillar crypts and B-lymphocytes during the incubation period.

The first infection with the virus in socially unfavorable countries / families occurs in childhood, mainly up to 3 years. In advanced economies and high level of life, the maximum infection occurs at the age of 15-18 years. Manifesting lesions are more recorded among males. And the reactivation of the infection is facilitated by factors that reduce local / general immunity and can occur at any age.

Factors contributing to the activation of the Epstein-Barr virus infection:

• genetic predisposition.
• Prolonged exposure to stress factors.
• Pathology of ENT organs, frequent infectious diseases of the upper respiratory tract.
• Decrease in general / local immunological reactivity of the organism.
• Chronic intoxication (abuse of alcohol, emissions of harmful substances into the atmosphere).
• Chemotherapy/irradiation.
• Vaccination.

Epstein Barr symptoms

Currently, a number of syndromes and diseases are associated with EBV. Consider only the main, most common diseases. There are primary acute manifesting infectious process - infectious mononucleosis (synonyms: Filatov's disease or Filatov's symptom) and chronic EBV infection. Clinical variants of primary Epstein-Barr virus infection can occur in asymptomatic form, in the form of respiratory syndrome or infectious mononucleosis. Chronic EBV infection - in the form of erased forms and chronic active Epstein-Barr virus infection.

Epstein-Barr virus symptoms in adults

In adults, Epstein-Barr virus infection most often occurs in the form of infectious mononucleosis (THEM). The latent (incubation) period of the disease varies within 4-7 weeks. In most cases, the disease begins acutely with an increase in temperature to febrile numbers and an increase in symptoms of intoxication. The clinical symptom complex includes several characteristic syndromes - lymphoproliferative (lesion of the nasopharynx, acute, with hypertrophy of the lymphoid tissue); lymphadenopathy (lymph node syndrome) and hepatosplenomegaly . Their formation takes an average of 5-8 days.

• Nasopharyngeal syndrome. Its early manifestation is pharyngitis with severe hypertrophy of the nasopharyngeal lymphoid tissue, which manifests itself adenoiditis , difficulty breathing through the nose, snoring during sleep, sore throat. characteristic symptom MI is tonsillitis , manifested by hyperemia of the mucous membrane of the soft palate, and hyperplasia of the lymphoid follicles of the pharyngeal ring. It can proceed in a catarrhal, lacunar or ulcerative-necrotic form with long-term preservation of raids (up to 7-14 days), sometimes of a fibrinous nature. In cases with a secondary infection, ulcerative and ulcerative-necrotic plaques are noted on the surface of the tonsils, the hyperplasia of which reaches II-III degrees.
• Syndrome of the defeat of the lymph nodes. It is manifested by a predominant and typical increase in the anterior-posterior lymph nodes. Less often, several groups of lymph nodes are involved in the process, including bronchial / mesenteric ones. The nodes are mobile, dense, painless / moderately painful, the skin over them is not changed, swelling around the lymph nodes of the subcutaneous tissue is not typical, in some cases - pastosity of the tissues. Cervical in some patients may be accompanied by pastosity of the eyelids or puffiness of the face.
• Syndrome hepatosplenomegaly . Splenomegaly develops from the second week of the disease, approximately in 50% of patients and persists for a long time, and is typical for most cases.
• Syndrome. It is registered in 10-18% of patients, appears on the 5th-10th day of the disease and manifests itself as an abundant maculopapular or hemorrhagic rash, sometimes confluent with localization on the limbs, trunk, face. In some cases, facial swelling and itching. The duration of the rash period does not exceed 10 days, and the reverse development occurs gradually over 1-2 weeks of illness and may be accompanied by peeling.

Atypical forms of MI:

• Erased: proceeds in the form of acute respiratory diseases with mild, rapidly passing symptoms.
• Asymptomatic: proceeds with the absence of symptoms and is diagnosed in saliva or lymphocytes by laboratory analysis methods - PCR.
• Visceral form: characterized by a severe course with involvement in the process of the central/peripheral nervous and cardiovascular systems, kidneys, adrenal glands.

The symptoms of chronic EBVI are extremely polymorphic. More often they are manifested by weakness, prolonged unexplained genesis, lymphadenopathy, arthralgia /myalgia , soreness in the lymph nodes. There is chronic fatigue. The disease has an undulating course, often there are layers of opportunistic infections.

Chronic active EBVI is characterized by symptoms similar to infectious mononucleosis , however, they are less pronounced, and the duration of the disease is more than 6 months. Much less often, chronic active EBVI manifests itself, pneumonia , uveitis , hypoplasia bone marrow. In patients with severe immune deficiency, there is a risk of developing generalized forms of EBV infection, which are characterized by CNS lesions ( , cerebellar ataxia ) and others internal organs( , heavy forms hepatitis A ).

Epstein Barr virus symptoms in children

In most cases, in children, the symptoms of Epstein-Barr virus infection consist of supporting clinical syndromes characteristic of adults. However, primary infection with the virus in almost 50% of children is asymptomatic. Infectious mononucleosis in children has similar characteristic syndromes, but the course of the disease has some features.

First of all, it is shortened to 10-20 days incubation period. The disease proceeds with a more pronounced intoxication syndrome (high body temperature), an increase in adenoid vegetations, grade 3-4 tonsil hyperplasia, asthenovegetative disorders, hypertrophy of the submandibular lymph nodes. In almost 40% of a third of children, acute EBVI occurs in the form of a mixed infection (with simple herpes , cytomegaloviruses , streptococci , staphylococci , Klebsiella , chlamydia or with associations of bacteria), which leaves an imprint on clinical manifestations.

The clinical symptoms of chronic EBVI in children are characterized by a recurrent long-term course and are manifested by weakness, subfebrile condition , difficult nasal breathing, pain in the joints / muscles, discomfort in the throat, rash, headaches, cough, heaviness in the right hypochondrium, emotional lability, sleep disturbance, severe asthenic syndrome. Epstein-Barr syndrome in children often occurs with the development tonsillitis , adenoiditis , hepatosplenomegaly different expression. In most cases, the symptomatology has a wave-like manifestation.

Analyzes and diagnostics

Material for laboratory research are: blood, sputum, urine, saliva, scrapings from the pharynx, swabs from the nasopharynx. Laboratory diagnostics includes the determination of antibodies to the antigens of the EB virus in the blood and the detection of DNA and AG of the pathogen.

An analysis for the Epstein Barr virus (a serological method for confirming EBV infection) includes laboratory tests to determine specific antibodies . In addition, the identified type of antibodies allows you to determine the stage of the infectious process.

Deciphering a blood test for the Epstein-Barr virus (ELISA method):

• The presence of IgM antibodies to the VCA capsid antigen are a serological marker of acute infection (they persist in 75% of blood patients for up to 3 months).
• The presence of IgG antibodies to the EBNA nuclear antigen (IgG positive) is a serological marker for the end of the acute stage of infection.
• The presence of IgG antibodies to VCA serve as a serological marker of past EBV infection.

Below is a summary table of the presence of antibodies in the blood and a breakdown of their presence at different stages of the disease.

• Blood test - a classic clinical and laboratory manifestation of EBV infection is leukocytosis with absolute in combination with the presence of more than 10% of atypical mononuclear cells (CD-8 T-lymphocytes).
• The PCR method (polymerase chain reaction) - allows you to determine the presence of EBV DNA in blood plasma at the earliest stage of infection, when antibodies to virus antigens are not yet detected (window period). One of the most effective methods diagnosis and monitoring of EBV infection, especially in immunocompromised individuals and children under 2 years of age.

Differential diagnosis is carried out with, adenovirus infection , pseudotuberculosis , .

Treatment of Epstein-Barr infection

First of all, where are patients with EBV infection treated? In most cases, isolation of the patient in the hospital is not required and treatment is carried out on an outpatient basis. Hospitalization is indicated only in cases of prolonged persistent, airway obstruction , expressed , syndrome tonsillitis , abdominal pain and in cases of neurological, surgical and hematological complications.

Epstein Barr treatment in adults

To date, the question of how to treat EBV infection in adults remains debatable. Most authors believe that in mild/moderate EBV MI, it is advisable to recommend general or semi-bed rest to patients. Current evidence suggests that the often recommended unreasonably strict bed rest is accompanied by a long-term asthenic syndrome and prolongs the recovery time. Bed rest may only be recommended for a period fever . In the acute period of the disease - isolation of the patient.

In case of mild course, treatment can be limited to supportive therapy, including, with severe discomfort in the throat, rinsing with antiseptic solutions in combination with / Xylocaine , adequate hydration. Symptomatic therapy is carried out:

• with fever, antipyretic drugs are prescribed (, etc.);
• with dry cough -, Glauvent ;
• with a wet cough - mucolytic / expectorant drugs (, etc.);
• with difficulty breathing through the nose - nasal preparations (, etc.).

A controversial issue is the appointment of antiviral drugs in patients with EBVI. There is a list of drugs that have an inhibitory effect on the replication of the Epstein-Barr virus in cell culture. These drugs include:

• acyclic nucleoside analogues ( , Valganciclovir ), which inhibit the activity of DNA polymerase of the EB virus;
• acyclic nucleotide analogs ( Adefovir , Cidofovir );
• pyrophosphate analogues ( Foscarnet , Phosphonoacetylic acid ).

However, it is important to understand that most of the symptoms are not directly related to the direct cytopathic effect of the EB virus, but are due to an indirect immunopathological response of B-lymphocytes infected with the virus, which are located in the tissue cells of the affected organs and in the blood. Therefore, some of them (analogues of nucleosides - Acyclovir , Ganciclovir ) do not have a significant clinical effect on the severity/duration of symptoms. When prescribing antiviral drugs, it must be understood that the clinical efficacy of these drugs also depends on the correct interpretation of the symptoms of the disease, the stage of the infectious process, and (very importantly) the development cycle of the virus at each stage.

Most experts believe that the appointment of antiviral drugs in mild and moderate forms of the course is inappropriate. Indications for their use may be a severe/complicated course of the disease in immunocompromised patients in order to prevent EBV-associated leukoplakia and B-cell lymphoproliferation.

In the complex therapy of EBVI, the introduction of immunoglobulins (intravenously) is recommended - ( Alphaglobin , Immunovenin , Gammar-P , Gabriglobin , Sandoglobulin , intraglobin , ) and recombinant alpha-interferons ( , ). In a severe form of the disease, as an interferon inducer, you can use Cycloferon .

The feasibility of prescribing antibacterial drugs is controversial. According to most authors, the prescription of antibiotics is justified only when a bacterial infection or complications are attached ( pneumonia , pleurisy ). The choice of drug depends on the sensitivity of microorganisms on the tonsils to antibiotics.

For this purpose, both local antibacterial agents ( , ) and systemic antibacterial drugs ( macrolides cephalosporins , carbapenems ) - , cephalosporin , ; when joining a fungal infection -,.

In chronic EBVI with the development of asthenic syndrome, adaptogens are prescribed (, rhodiola rosea , ginseng , aralia , lemongrass , ginger ), complex vitamin and mineral preparations (, Multi-tabs , Vibovit , ).

According to indications, basic therapy can be intensified by adding immunomodulators (