Mononucleosis is a viral infection caused by the Epstein-Barr virus in 95% of cases. This is a type of herpes virus that is transmitted mainly through saliva. In 5% of cases, mononucleosis is associated with other pathogens, such as HIV, toxoplasmosis, rubella, hepatitis A, adenovirus and cytomegalovirus infection. Mononucleosis is not very common for adults, so this condition mostly affects teenagers.
Content
- Diagnostics
- Treatment
- Prognosis
It is enough to take antipyretics, drink plenty of water, and humidify the air to cure most cases of the disease. Sometimes antivirals and corticosteroids may be required as well. Some patients develop severe complications of mononucleosis requiring additional treatment, including surgery.
You can undergo your treatment in one of the following hospitals: University Hospital Ulm, University Hospital Essen, or University Hospital Duesseldorf.
The specialists of the Booking Health company will take care of all your organizational issues. They will provide you with information about the best clinics and doctors; they will help you to quickly make your appointment, get a visa and come to the clinic; they will tell you about possible treatment options; they will provide medical insurance and control invoices from the clinic. If necessary, our employees will organize additional examinations or rehabilitation. Your interpreter will help you to communicate with doctors, and you can contact your personal coordinator 24/7 for any everyday issues.
Diagnostics
The following classic triad of symptoms manifests the disease:
- fever is a rise in body temperature;
- pharyngitis is an inflammation of the mucous membrane of the pharynx and tonsils in this region;
- lymphadenopathy causes lymph node enlargement.
Other possible symptoms may include headache, fatigue, or loss of appetite.
When examining a patient, a doctor finds enlarged lymph nodes on the back of the neck. Half of the patients have an enlarged spleen: a doctor can determine this by palpation or with the help of an ultrasound scan.
Half of the patients develop hepatitis. A quarter of the patients have an enlarged liver. The severity of hepatitis usually corresponds to the severity of the disease.
3% of patients develop jaundice. This condition can be associated with both hepatitis and the destruction of red blood cells (hemolytic anemia).
Occasionally, a maculopapular rash develops on the skin.
The main way to confirm the diagnosis is a heterophile antibody test. The Epstein-Barr virus test is less commonly used. Doctors may also check for HIV, toxoplasmosis, and cytomegalovirus to rule out other infections.
Treatment
Patients with uncomplicated cases receive symptomatic and maintenance treatment. Fever can be eliminated with nonsteroidal anti-inflammatory drugs. Occasionally, there is a need for corticosteroids if the airway is blocked and shortness of breath develops. Mononucleosis does not require antibiotics.
In severe cases, mononucleosis can cause complications. It is in such situations that patients from other countries undergo their treatment of mononucleosis in Germany, since standard mild cases do not require the help of the best doctors in the world.
Complications of mononucleosis often develop in patients who are weakened by concomitant diseases of the internal organs or who have immunodeficiency, including due to the constant use of immunosuppressants, due to cancer treatment, etc. Possible complications include:
- encephalitis, meningitis, peripheral neuropathy, or cranial nerve dysfunction;
- hematological complications: the number of platelets in the blood can be significantly reduced, which will lead to bleeding, many patients develop anemia due to the breakdown of red blood cells;
- a ruptured spleen occurs in 1% of patients, and they may require surgery to remove it (surgeons in Germany perform it using a minimally invasive laparoscopic technique);
- an airway obstruction can usually be eliminated with medications;
- other complications include pneumonia, pleurisy, myocarditis, glomerulonephritis, otitis, sinusitis, or pancreatitis.
Mortality in mono is about 1%. The top three causes of death are encephalitis, an airway obstruction and a ruptured spleen.
In the case of a severe infection, it is better to seek medical attention from one of the modern German hospitals to reduce the risks of the disease. An adequate therapy will facilitate a lower risk of complications, and, if they develop, a patient will receive timely medical care. As a result, getting rid of mononucleosis without health consequences will be possible.
Prognosis
The disease usually goes away no later than 2-4 weeks. The lymph nodes, liver and spleen can be enlarged for several months. The course of cytomegalovirus-associated mononucleosis is longer than that of EBV-associated mononucleosis.
Sometimes symptoms persist for a long time. These may be fatigue, weakness, poor sleep, etc. The Epstein-Barr virus remains in the body for life, but patients have immunity to fight it, and new episodes of the disease are unlikely.
After suffering infectious mononucleosis, patients with a genetic predisposition may develop lymphoma. This is associated with chromosomal aberrations in lymphocytes: the percentage of immune cells with an abnormal number of chromosomes and the presence of micronuclei increase in the blood. Doctors in Germany successfully treat lymphoma in most patients.
You can undergo your diagnostics, treatment and rehabilitation for infectious mononucleosis in one of the German hospitals if the disease is severe or has caused complications. You are welcome to visit the Booking Health website to see the prices in different medical centers. When making your treatment appointment through our service, the cost of medical services for you will be lower than when contacting the clinic directly due to the lack of additional fees for foreign patients. The Booking Health specialists will help you to choose the most suitable clinics in Germany and organize your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
WHO - World Health Organization
Web MD
Medscape
