Readers may be surprised (and especially those working in the field of medicine) at first glance when giving to address this issue, and specifically the relationship antibiotic "amoxicillin" Amoxicillin glandular fever. It is known that glandular fever is a viral disease does not benefit antibiotics in the treatment, on the one hand, while on the other hand, how to use this antibiotic in the diagnosis of the disease?!
All studies indicated that approximately 82-92 percent of patients with glandular fever Glandular Fever and also called the disease "monocytes nucleus Alkh." Infectious Mononucleosis appears on their bodies rash when eating the antibiotic "Amoxicillin" What is glandular fever? And how is it diagnosed?
Known disease and monocytes nucleus (glandular fever) as an infectious disease, acute viral, and widespread. One of the main symptoms and signs: high body temperature (fever), pain in the throat as a result of pharyngitis Pharyngitis, ill glandular lymphocytic Lymphadenopathy and the high number of abnormal lymph leukocytes (not typical) in the blood Atypical Lymphocytosis.
And the causative agent of disease and monocytes nucleus, is a virus Epstein-Barr Virus (and symbolizes his EBV). A type of herpes viruses Herpes Virus.
Methods of infection
Infection disease and monocytes kernel in the first place by mouth, and when it enters the saliva of the person carrying the virus (or patient) oral cavity proper person by direct intimate contact between them (kiss). Hence the name of this disease in the vernacular "kissing disease" Kissing Disease.
And also may be transmitted the disease through contact indirect, through the use of a spoon or cup sick person or pregnant for the virus (known as the person carrying the virus that that individual who carries the virus without showing symptoms and signs of the disease, but can infect people sound).
The children specifically talked infection in case of exchange of children candy or fruit from mouth to mouth.
Well it is likely that the infection transmitted through mucous secretions from the nose and throat during coughing and sneezing, and sometimes through tears.
The recorded some rare cases in which the infection through direct sexual contact with the female reproductive tract, and that the presence of the virus in the cells of the cervix. Let alone documented some cases in which the infection through blood.
Pathophysiology
After entering EBV virus mouth of a healthy person, the attacking white blood cells lymphocytes Lymphocytes Type B in the epithelium Epithelium of the mouth, pharynx and salivary glands, and signs of infection appear. And then you lymphocytes deployment and delivery of infection by blood circulation to the reticulo-endothelial system Reticular Endothelial System (liver, spleen, peripheral lymph nodes).
And leads the immune response against infection by the virus to high body temperature, and the emergence of large white ball size, not to mention that the invasion of the virus to cells of the type B specifically leads to change shape model to a new format is typical breed in great numbers.
And back high white blood cell count in lymph reticulo-endothelial system in general, to the proliferation of lymphocytes of type B virus infected. While sore throat due to the proliferation of the same pellets within lymphoid tissue in the mouth and throat area.
On the other hand, as a reaction to the virus entering the body the immune system produces antibodies to attack the virus and eliminate the intruder or weakening. The remainder of these antibodies in the body and gives a person immunity against the same virus for life.
However, after the improvement remains latent virus within the body until re-activated from time to time (like the rest of viruses Lhala - see the chicken pox and the Ring of Fire - two cases Mredatan are Espbhma different single virus - Dr. Gabi Kevorkian www.Altibbi.com). Thus a person becomes a carrier of the virus and will pass the disease to people who have never and infected.
Diffuse ratio
Glandular fever and widespread and very common, have studies indicated that more than 93 percent of adults (on a global scale) have been subjected during their lives of infection with EBV, and enjoy immunity against the virus, but they carrying him (and know the person carrying the virus that it the person who harbors the virus, without showing signs and symptoms of the disease, and that person is able to pass on the infection to healthy people who do not enjoy immunity against the virus).
The studies indicated also that most people are exposed to EBV virus in childhood, and the symptoms and signs of disease have a very simple, or it may be similar to infection upper respiratory tract, Owalthab tonsils, which may lead some doctors to diagnose this case as a bacterial infection of the respiratory system top, and they give the patient antibiotics unnecessary, and that the viral situation does not benefit the antibiotic in this case. It is important here to recall and emphasize that if the antibiotic used is Amoxicillin or Augmentin it in 92 percent of cases appear on the patient after two or four days of his handling of the antibiotic characteristic rash (will explain later) leads to believing parents error (and sometimes doctors) that this reaction is the sensitivity of Allergy to these antibiotics. However, many doctors take advantage of this phenomenon to confirm that the patient is suffering from glandular fever.
It is worth noting that in developing countries (non-advanced) people are exposed to glandular fever infection in childhood, while exposed a large percentage of people in the developed countries of the infection at the age of adolescence and adulthood. Therefore, doctors in developed countries are viewing the classical clinical picture of the disease (while in developing countries with the situation over the customers).
The estimated annual percentage extensive glandular fever (injuries during the 12-month period) by about 20-70 people from every hundred thousand people. While adolescents this percentage will increase to up to one person out of every thousand people.
Clinical picture
The incubation period for glandular fever than a month to two months (incubation period is defined as the time period from the moment of entry of the virus into the human body, and even the appearance of the first signs and symptoms of the disease).
In our country are so many people to the virus in childhood, as he does not show signs and symptoms of disease are evident and clear, and be in the form of a sore throat and a slight increase of temperature.
As if a person is exposed to infection at the age of adolescence or adolescence, the signs and symptoms are more obvious and classic.
And characterized the early symptoms of the disease, including the following: fatigue, malaise and pain in the skeletal muscles of the body. The last of these symptoms than a week to two weeks, followed by symptoms and signs clearer and more distinct fever glandular, are: high body temperature, pain in the throat area (due to sore throat or tonsillitis) and morbidity and swollen lymph nodes in general and in the neck area in particular.
Important Notes
Be an acute onset of the disease - a sudden, the show has several distinctive symptoms and signs, (previously mentioned), but I would like the expansion of the clinical picture is showing interest to do so.
Symptoms: supply is defined as self-directory (feeling) of the disease, and who feel or felt by the patient and informs the doctor. Example of this patient's complaint of pain in the throat or fatigue.
I would like to stress the following in regards to glandular fever patients:
• All patients suffer from fatigue and long-term malaise.
• sensation of pain in the throat area comes in second place after the fatigue and malaise.
• Do not exceed the oral temperature about 38 degrees Celsius Low Grade Fever.
• joint pain and skeletal muscle occurs less compared with other infectious diseases.
• often the patient suffers from loss of appetite Anorexia and nausea (without vomiting).
• the patient may suffer from cough and pain in the chest area and photophobia Photophobia (intolerance to his eyes to light).
Tags: brand is defined as a local directory (non-self) of the disease, and who feel or felt or noticed by the patient's doctor during the examination. An example of this Note doctor patient redness shave or a sense of the size of the lymph glands inflation in the neck area while he put his hand on this region.
Here, I would like also to emphasize some observations:
• First signs of the disease include: high body temperature, poor lymphatic glandular, sore throat (pharynx) and swelling around the eye and sometimes rash may appear.
• Then notes enlarged liver and spleen, jaundice, and red spots in the roof of the oral cavity Palatal Petechiae in rare cases may lead an enlarged spleen to torn (1-2 percent of cases), especially in the case of a patient lift something heavy or suffering from constipation (what lead to the lifting of the pressure within the abdominal cavity during defecation).
• The classic signs and symptoms of the disease in children and adolescents, including the following: high body temperature, sore throat and ill lymph glands. Whereas the clinical picture in older persons and the elderly, without the emergence of hepatitis jaundice. In the case of his appearance in general, it appears when young by only 11 percent of the cases, while in the elderly than this percentage, 29 percent.
• often enlarged tonsils, and may even be to clog the patient's tonsils shaved consequent difficulty swallowing or shortness of breath.
• at the beginning of the disease may appear rash all over the body without itching, and fading fast.
I would like to take this paragraph to draw the attention of parents and doctors that if diagnosed case an error on the basis that it sore throat caused by bacteria Streptococcus and give the patient a antibiotics following Ampicillin, Amoxicillin, Augmentin, it may appear a rash on the chest, abdomen and back area (without head and the parties) and that after taking antibiotics three or four days. And this rash disappears completely after you stop giving these antibiotics. It is not known why this rash appears, is that many doctors and parents mistakenly believe that this rash caused by allergies Allergy to antibiotics three previously mentioned.
Thus recorded on the patient suffers from allergies towards it, and this fatal error (as the rash caused by sensitivity to antibiotics appear very quickly and suddenly after eating counter for less than an hour).
• enlarged spleen occurs in the late stage of the disease, and its size due to the normal size after 3 weeks of Note amplified.
• rarely patient suffers from anemia (anemia).
• increase the number of leukocytes (rather than decrease, as is the case in most viral infectious diseases) and because of the relatively high remarkable number of leukocytes lymph Lymphocytes Alanmozjah and characteristic of this disease.
Often diagnosed disease and monocytes core teen, and be top of the infection and the incidence of the disease at the age of 15-17 years. It also noted in childhood, but it has similar symptoms with symptoms of other common childhood diseases, and this explains the lack of or lack of diagnosis and monocytes nucleus in infancy.
Complications of the disease
In very rare cases complications may arise as a result of the disease monocytes nucleus, namely:
- Anemia Anemia: a shortage of hemoglobin Hemoglobin level and the number of red blood cells.
- The lack of platelets Thrombocytopenia: decreased number of blood platelets responsible for blood clotting.
- Myocarditis Myocarditis.
- Meningitis Meningitis.
- Encephalitis Encephalitis.
- Pancreatitis Pancreatitis.
- Cholecystitis Cholecystitis.
- Glomerular nephritis Glomerular Nephritis.
- Myositis Myositis.
- Inflammation of the mesenteric lymph glands Mesenteric Adenitis: The case inflamed lymph nodes that combine lymphatic fluid Lymph from the intestine in the abdominal area. A condition similar symptoms and markings of acute appendicitis.
- Optic neuritis Optic Neuritis.
- Inflammation of the spinal cord browser Transverse Myelitis.
- Multiple Sclerosis Multiple Sclerosis.
Lab tests
Antibodies: as a result of resistance the body's immune system, antibodies are produced Antibodies against EBV virus which can be detected in the blood of the patient in the first week after the onset of symptoms.
White blood cells: increase the percentage of leukocytes from lymphatic type Lymphocytes. It may be noted the high number of atypical lymphoid leukocytes.
Prevention and treatment
Since the only way to move disease and monocytes nucleus is through saliva, so you should not the person who is sick or pregnant for the virus (during activation virus), kissing others by mouth (is it allowed that the Baandanam), also should not share with others the same dish food, spoon or cup, until the demise of fever and after a week or two. There is no vaccine Vaccine for the prevention of disease and monocytes nucleus.
And also there is no special treatment for the treatment and control of disease and monocytes nucleus, and the antibiotics Antibiotics not useful here at all, because the viral disease. The treatment (after proper diagnosis) sticking bedding and drinking enough fluids.
As in the case of the emergence of a secondary bacterial infection, especially in the throat area, it is possible to use antibiotics provided away from "amoxicillin" and "Alaugmenten", since as I mentioned earlier may appear as a result dealt with a rash particular (note that the use of the antibiotic "ampicillin" may Overall halted since over 26 years).
In a study by the author of this article (d. Gabi Kevorkian) in the occupied city of Jerusalem and its environs, in 2006 found that 79.2 percent of children with diabetes and monocytes nucleus, diagnose fault that they suffer from allergies adversaries vital "amoxicillin" "Alaugmenten" if eating them during the treatment period, and thus deprived of taking these antibiotics throughout their lives.
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