Infectious mononucleosis

ICD-9: 075

Description

Infectious mononucleosis is an acute infectious disease characterized by sore throat, fever, and swollen cervical lymph glands. The disease primarily affects adolescents and young adults. It is also called glandular fever.

Etiology

Infectious mononucleosis is caused by the Epstein-Barr virus (EBV). This virus is shed in the saliva of infected individuals and is usually spread through the oral-pharyngeal route (the reason for another name: the “kissing disease”). Once in the body, EBV infects B lymphocytes, a type of white cell found in the lymph, blood, and connective tissue, that are one important component of the body’s immune system. Infectious mononucleosis is most likely contagious for a period before symptoms develop until the fever subsides and the oral-pharyngeal lesions disappear.

READ:   RESPIRATORY SYSTEM ANATOMY AND PHYSIOLOGY REVIEW

Signs and Symptoms

Initial symptoms are usually vague, mimic those of other diseases, and may include malaise, anorexia, and chills. After 3 to 5 days, sore throat, fever, and swollen lymph glands in the throat and neck occur. Early in the infection, a rash that resembles rubella sometimes develops.

Diagnostic Procedures

A thorough client history and physical examination are essential to rule out closely related disorders and will reveal the triad of symptoms: (1) sore throat, (2) fever, and (3) swollen lymph glands. A blood test is necessary to confirm the diagnosis. It will show increased numbers of leukocytes, lymphocytes, monocytes, and antibodies to EBV.

READ:   Pleural effusion

Atypical lymphocytes seen in infectious mononucleosis

FIGURE. Atypical lymphocytes seen in infectious mononucleosis. (From Thomas, CL [ed]: Taber’s Cyclopedic Medical Dictionary, ed 21. FA Davis, Philadelphia, 2009, p 1488, with permission.)

Treatment

Treatment is supportive because mononucleosis resists prevention and antimicrobial treatment. Bed rest may be indicated during the acute phase, but clients may still need to lessen their activities until the disease completely subsides. Analgesics may be recommended for headache and sore throat. Warm saline gargles are also helpful.

Complementary Therapy

Bed rest is especially important in the acute phase of the infection. It is recommended that clients drink plenty of water, filtered to remove chlorine, heavy metals, benzene, lead, and mercury, and eat organic meats, eggs, milk, and poultry that contain no growth hormones or antibiotics. Vitamin supplements may be recommended.

READ:   Pneumoconiosis

CLIENT COMMUNICATION

Stress adequate rest and reduction of activities. Clients may suffer from ongoing fatigue during much of the period of infection and tend to resume normal activity too quickly.

Prognosis

The prognosis is excellent, but recovery may take several weeks or months. Once infected with EBV, the virus remains—usually in a dormant state—for life. If the virus does reactivate, it does not cause illness. Mononucleosis sometimes leads to a serious condition called chronic active EBV infection, which causes illness more than 6 months after the initial diagnosis.

Prevention

The best prevention is to avoid oral-pharyngeal contact with a known EBV-infected person. Do not share dishes or eating utensils with someone who has mononucleosis. (EBV virus is spread when saliva from an infected person gets into another person’s mouth.)

READ:   Respiratory mycoses
Understanding Nosebleeds Nosebleed, or epistaxis, is more likely a symptom than a disorder or disease. Bleeding from the nose is more common in winter months that are likely cold and dry. It is more common in children and older adults. Nosebleeds are usually not considered serious, but some circumstances call for medical attention by a health-care professional because of possible underlying causes. They are: Repeated nosebleeds Syncope Hematemesis or hemoptysis Nosebleeds commonly occur due to nose picking or nose trauma but may be secondary to rhinitis, hypertension, chemotherapy treatment, certain illnesses, and blood-thinning medications. Secondary nosebleeds should be reported to a medical professional. To treat a nosebleed, have the client lean forward and press the soft portion of the nostrils against the septum for 10 minutes (pinch the nose). Apply cold, wet compresses. A vasoconstricting agent such as epinephrine on a cotton ball may be applied to the bleeding site. Cauterization or petr...
Lung abscess ICD-9: 513.0 Description A lung abscess is an area of necrotized lung tissue containing purulent material. Abscesses are more frequent in the lower dependent portions of the lungs and in the right lung, which has a more vertical bronchus. Etiology Lung abscesses caused by infectious organisms may be a complication of pneumonia. Aspiration of infectious material is the most frequent etiology; however, aspiration due to dysphagia or compromised consciousness (e.g., seizure, cerebrovascular accident, head trauma, alcoholism) appears to be a predisposing factor. Poor oral hygiene, dental infections, and gingivitis are also common indicators. Antibiotic therapy has greatly decreased the number of deaths caused by lung abscess. However, the increased use of corticosteroids, immunosuppressive drugs, and chemotherapeutic agents in the past couple of decades has changed the natural environment of the oropharyngeal cavity and contributed to increased frequency of opportunistic lung abs...
Pneumoconiosis ICD-9: 505 Pneumoconiosis is a disease of the respiratory tract caused by inhaling inorganic or organic dust particles or chemical irritants over a prolonged period. It is an occupational disorder associated with mining and stonecutting. Four of the most frequently seen varieties of pneumoconiosis are silicosis (most common), asbestosis, berylliosis, and anthracosis.
Cor pulmonale ICD-9: 416.9 Description Cor pulmonale is hypertrophy and failure of the right ventricle of the heart. Lung disease may cause pulmonary hypertension. As a result, the workload of the heart is increased, and the right ventricle hypertrophies in an effort to force blood into the lungs. Eventually the right ventricle is weakened by this effort, and blood pools in the right ventricle. Etiology Cor pulmonale is caused by various disorders of the lungs, the pulmonary vessels, or the chest wall that impede pulmonary circulation. Disorders that may lead to cor pulmonale include COPD, bronchiectasis, pneumoconiosis, pulmonary hypertension, kyphoscoliosis (abnormal backward and lateral curvature of the spine), multiple pulmonary emboli, upper airway obstruction, and living at high altitudes. The condition may be acute but is more commonly chronic. Signs and Symptoms Signs and symptoms include a productive, chronic cough; exertional dyspnea; fatigability; and wheezing respirations...
Atelectasis ICD-9: 518.0 Description Atelectasis is a collapsed or an airless condition of all or part of a lung that allows unoxygenated blood to pass unchanged through the area; this produces hypoxia. The condition may be acute or chronic. Etiology The condition may be caused by obstruction of the lung by foreign matter, mucus plugs, or excessive secretion. It is seen in many clients with COPD or cystic fibrosis and those who smoke heavily. Compression of the lung by tumors, aneurysms, enlarged lymph nodes, or pneumothorax also may cause lung collapse (see Pneumothorax). Atelectasis is sometimes a complication of abdominal surgery or a general consequence of postoperative immobilization. Signs and Symptoms Chronic atelectasis may be marked only by the gradual onset of dyspnea. Acute atelectasis typically includes marked dyspnea, cyanosis, fever, tachycardia, anxiety, and diaphoresis (profuse sweating). There may be a decrease in chest motion on the affected side. Chronic atelecta...