International Medical Journal, Vol. 20., Iss. 2, 2014, P. 90−95.
CARDIAC COMPLICATIONS IN INFECTIOUS MONONUCLEOSIS IN ADULTS
Kharkiv Medical Academy of Postgraduate Education
V.N. Karazin Kharkiv National University
In the recent years infectious mononucleosis has been frequently diagnosed in adults. This is caused by Epstein−Barr virus of herpes virus subfamily. This virus is a lymphotropic agent causing syndromes of lymphoproliferation and immune insufficiency associated with the damage of the heart, central and peripheral nervous system, kidneys, glands. 186 patients with immune mononucleosis and diagnosed acute myocarditis were examined to study the frequency of development, peculiarities of clinical course and treatment of acute myocarditis in adults. It was established that myocarditis in this group of patients can be symptom−free, the clinical presentation can be masked by the primary infection process. Clinical, laboratory (increased lactate dehydrogenase−1, asparagin transamylase, MB creatinphosphategenase and troponin−1), electrocardiography, echocardiography, x−ray methods play a great role in the diagnosis of myocarditis in this group of patients. Within the period of active virus replication it is necessary to perform virology and laboratory investigations with the purpose to control the changes in the infection process and reverse development of complications. Medication for myocarditis in patients with infectious mononucleosis must include antiviral drugs (Acyclovir or Gancyclovir), drugs influencing inflammatory, autoimmune, allergic reactions, restoration and maintenance of hemodynamics, effect on metabolism of the myocardium, symptomatic complications therapy.
Key words: infectious mononucleosis, myocarditis, diagnosis, treatment, Epstein − Barr virus, acyclovir, ganciclovir.