The dissertation is devoted to the study of the influence of herpesviruses 4,5,6th types and their associations on the severity and duration of clinical and paraclinical manifestations of infectious mononucleosis in children, the development of an algorithm for predicting the course of the disease, and the search for ways to improve its therapy.
The study was conducted on the basis of the city clinical infectious diseases hospital of Odessa during 2015-2019, 400 children aged 10 months. up to 12 years of patients with infectious mononucleosis of various etiologies and severity were thoroughly examined.
As a result of our study, it was found that the sole causative agent of infectious mononucleosis in only 35% of patients was Epstein-Barr virus, but most often in 54% of the disease is caused by associations of herpesviruses. MIXT infectious mononucleosis in children is represented by various combinations of herpesviruses of the 4th, 5th, and 6th types. However, co-infection with Epstein-Barr virus and cytomegalovirus was most common in almost 77%. A study of the incidence over a 5-year period found that cases of infectious mononucleosis were registered throughout the year. The largest number of patients was observed in the cold period of the year up to 16.4%, and in the warm-up to 8.39%. With regard to clinical manifestations, the data obtained by us indicate that the severity, duration, and course of clinical and paraclinical manifestations of infectious mononucleosis, largely depends on the pathogens and their associations. Indicators of paraclinical examination also depend on pathogens. To confirm the effectiveness of glucocorticosteroids in combination therapy, we selected 88 children with infectious mononucleosis of various etiologies, who received a mathematical model of 30 or more points. The control group consisted of 38 children (data from a retrospective analysis of medical histories) with severe infectious mononucleosis, who did not receive glucocorticosteroids and also received 30 or more points according to the mathematical model. Positive dynamics in the improvement of well-being in children treated with glucocorticosteroids were observed 2-3 days earlier than the control group. Also, to increase the effectiveness of the treatment of infectious mononucleosis of various etiologies, ages, and severity, we included in the treatment of children a medicinal drug of plant origin hyporamine, which was used according to the instructions in age doses in children from 3 to 12 years. The results showed that the tool helps to reduce the duration and severity of the main clinical symptoms with a reduction of their average by 1.5 - 2 days. Significant indicators of the effectiveness of complex therapy using hyporamine were found during the assessment of the convalescence period. Thus, it was found that 20.0% of children within 1 month after recovery showed signs of chronic fatigue syndrome in the form of weakness, fatigue, the need for daytime sleep, and others. At the same time, in the group of children who received hyporamine during the treatment of infectious mononucleosis and after discharge, signs of chronic fatigue were observed in only 8.33% of children.
