Mononucleosis Symptoms and Treatment in Kids

What's Up with Mono in Kids

The main culprit behind the illness is the Epstein-Barr virus, which gets into the body through everyday items (like dishes and towels) or through kissing. Less commonly, the disease is diagnosed as being caused by cytomegalovirus.

The virus starts to multiply on the surface layers of the throat, from where it enters the bloodstream and is carried throughout the body, hitting the heart muscle, lymph nodes, liver, and other organs.

Mono in kids comes with a pretty clear set of symptoms. It only causes complications if there's an added infection from bacteria or fungi, especially when the immune system is down. This can lead to pneumonia, middle ear infections, sinusitis, or issues with other organs.

How long it takes for symptoms to show up depends on the kid's immune system and can range from 5 days to 3 weeks. After that, the acute phase kicks in (lasting from 2 to 4 weeks), marked by noticeable symptoms. Without proper treatment, it can turn into a chronic condition, spreading the infection and affecting other organs. After recovery, the kiddo becomes a carrier of the Epstein-Barr virus.

Forms of Mononucleosis in Kids

Mononucleosis in kids can be either typical or atypical. The typical form is known for its pronounced symptoms including fever, swollen tonsils, enlarged spleen, and liver. Additionally, a special type of white blood cells – mononuclears – show an increase in the blood.

The atypical form of this viral infection doesn't have the usual signs of the illness. Visceral damages to the CNS, heart muscle, and the bronchopulmonary system are rarely diagnosed.

Depending on the severity of the disease, mononucleosis can be mild, moderate, or severe.

What Mononucleosis Looks Like

After the incubation period ends, the first symptoms of the illness start to show up:

• Stuffiness and redness of the nasal passages and throat due to catarrhal symptoms;
• A low-grade fever;
• Feeling generally under the weather.

As the disease enters its acute phase, the kid's condition gets worse, and along with the symptoms mentioned, the following issues start to crop up:

• Fever;
• Chills;
• Dizziness;
• Swelling of the face;
• Heavy sweating;
• Body temperature spiking to critical levels (up to 102°F);
• Muscle and headaches;
• Insomnia;
• Pain and discomfort in the throat, which get worse when swallowing or talking.

A hallmark of mononucleosis in kids is the swelling of the lymph nodes in the back of the head, under the jaw, and behind the ears. Palpation makes the patient feel pain and discomfort. Also, the kid might show signs of tonsillitis: swelling and redness of the tonsils, a grainy texture on the surface of the throat, and pain. If bacteria join the party, white or yellow patches might form.

In adults, an increase in the size of the liver and spleen is noted.

A telltale sign of the illness is a mononucleosis rash, which shows up around the 3rd to 5th day of the acute phase. It looks like spots of pink, red, or burgundy that spread all over the body. They don't come with itchiness, and if you do start itching, it might mean you're having an allergic reaction to medication. With the right treatment, it clears up on its own.

Besides that, you might also get symptoms of bronchitis, pneumonia, jaundice, poisoning, and other diseases, with their development depending on how strong a kid's immune system is. Recovery usually happens in the 2nd to 4th week, though in rare cases, it can turn chronic and last up to a year and a half.

Diagnosis

The challenge of diagnosis lies in its similar clinical presentation to the common cold, strep throat, bronchitis, and other illnesses. In young children, the disease is accompanied by symptoms of the common cold including coughing, sneezing, runny nose, and wheezing when breathing. The clinical symptoms are most pronounced in patients aged 6 to 15 years.

To make a diagnosis, a blood test is ordered.

• A complete blood count to identify the inflammatory process in the body. With mononucleosis, there's an increase in ESR, white blood cells, lymphocytes, and monocytes. Atypical mononuclear cells in the blood only appear in the 2nd or 3rd week after infection.
• A biochemical analysis to determine the levels of sugar, proteins, urea, and other indicators that assess the functioning of the kidneys, liver, and other internal organs.
• An enzyme-linked immunosorbent assay for mononucleosis to identify antibodies to herpesviruses, the presence of which helps confirm the diagnosis. This test is mandatory and allows for the differentiation between mononucleosis and HIV.
• Polymerase chain reaction is ordered to determine the DNA of the pathogens.

If necessary, an ultrasound examination of the internal organs is conducted before treatment.

Complications

Without proper treatment, mononucleosis in children and in patients with weakened immune systems can lead to the following complications:

• Spleen rupture can occur with a sudden change in body position, a blow, or during strong pressure while palpating the abdominal area;
• Inflammation of the endocrine glands: thyroid, pancreas, salivary glands, and in boys, the testicles are often affected;
• Inflammatory processes in the heart muscle and sac;
• Autoimmune disorders;
• Decreased levels of hemoglobin in the blood;
• Secondary inflammatory processes due to the addition of bacterial flora in the bronchopulmonary system, the membranes of the brain, liver, kidneys, and other internal organs;
• Autoimmune reactions.

The infectious process also increases the risk of developing lymphomas - tumors of the lymphatic system when immunity is sharply decreased.

Most often in medical practice, consequences manifest as increased fatigue, so during the rehabilitation period, children need prolonged sleep, frequent rest, minimal physical and psycho-emotional stress, as well as a gentle diet.

Treating Mono in Kids

There's no specific treatment targeting the virus itself, so the approach is all about managing symptoms and supportive care.

Treatment is usually on an outpatient basis. Hospitalization is needed if there's a prolonged fever with body temperature hitting 104°F, fainting, severe signs of poisoning, complications developing, or asphyxiation.

It's a big no-no to use aspirin for mono, as it can speed up the virus spreading and lead to complications with the liver and other internal organs.

What's used to treat the illness:

• Antiviral meds with interferon;
• Fever reducers with ibuprofen or acetaminophen;
• Throat sprays with chlorhexidine, chamomile, or furacilin to ease pain and act as antiseptics;
• Antihistamines for any allergic reactions;
• Liver support meds to help with liver function and prevent complications;
• Bile flow stimulants to prevent liver complications;
• Corticosteroids to reduce throat swelling and prevent asphyxiation;
• Nonspecific immunotherapy;
• Vitamin and mineral complexes to boost the immune system;
• Probiotics and prebiotics to restore gut flora.

When a secondary bacterial infection joins the fray and complications arise, treatment is beefed up with antibiotics.

Daytime Routine and Diet Tips for Kids with Mono

When a kid's down with mono, it's crucial they stick to bed rest, cutting out any physical hustle or emotional stress.

Alongside meds, you can lean on some home remedies, like using chamomile tea for gargling, applying lemon balm leaves on rashes, or taking them orally for a calming effect. A special diet's also key. Ditch canned, spicy, salty, pickled, fatty foods, mushrooms, and processed stuff that irritate the gut and are hard to digest. The kiddo's meals should have dairy, porridge, poultry or lean fish, veggie soups, and grain-based soups made with secondary meat broth. Plus, staying hydrated is a must (water, natural juices and compotes, rosehip tea, herbal teas).

Preventing Mono in Kids

Preventing this illness boils down to boosting the body's defenses with the following actions:

• Getting vaccinated according to the immunization schedule;
• Frequent walks in the fresh air;
• Moderate physical activity;
• Acclimatization to the cold;
• Eating right;
• Regular cleaning and airing out your kid's room;
• Check-ups with the doc.

Mononucleosis, or mono, is an illness that can either hit hard or fly under the radar with its symptoms. It's marked by a fever, swollen lymph nodes, sore throat, and just feeling all-around crummy. Treatment is all about symptom relief and kicking the bad germs to the curb.