By Dr Ananya Mandal, MD
Glandular fever is most commonly caused by infection of young adults with Epstein-Barr virus.
The usual time between infection and manifestation of symptoms is between one to two months. This is called the incubation period.
Typical symptoms of glandular fever
Symptoms of glandular fever include (1-7):
- High fever with temperatures 38ºC (100.4ºF) or above
- Sore throat – The virus primarily infects the inner lining of the throat and the salivary glands. It may affect the tonsils as well.
Throat is painful and swollen making eating and drinking difficult. The throat may appear red and raw and may ooze secretions and mucus. There may be small purple spots on the roof of the mouth or palate.
- Swollen lymph nodes or glands in the neck and possibly other parts of the body like armpits.
The neck glands enlarge rapidly and may form a visible and palpable mass or tumor within 24 hours. The mass is normally painless or only slightly tender. The most characteristic gland is found at the side of the neck below the angle of the jaw.
- Extreme fatigue is a common symptom that may last long after the infection is gone
- A rash may be present all over the body. This rash often appears like other viral infection rashes like measles, German measles or rubella, chicken pox, allergic rash or typhus fever.
The rash in glandular fever is non-itchy and disappears quickly.
- Headache and eye pain
- Body aches and muscle pains
- Feeling of malaise and general illness
- Puffiness and swelling around the eyes
- Fever may be accompanied by chills, tremors or rigor and sweats
- Loss of appetite
- Painful swelling of the spleen. This may fell like a lump in the left upper side of the abdomen just under the left breast.
- Swelling of the liver that may lead to pain over the right side of the abdomen.
- Liver involvement may also cause jaundice. This leads to yellowish discoloration of whites of the eyes, nail beds, skin and inner lining of the mouth. There may be darkened or tea colored urine in severe cases.
- Some people become infected with EBV but do not develop symptoms. This is called a subclinical infection.
How long do the symptoms last?
The glandular fever symptoms usually resolve by themselves within two to three weeks of the initial infection.
Initial three to five days will be the worst followed by improvement in a gradual course.
The fever usually lasts for 10 to 14 days and declines in severity after the initial three to five days.
Fatigue however may persist for up to three to six months.
Normal activity may be resumed within one to two months of the infection.
In young children the onset of the glandular fever is usually short term. There is a short period of malaise followed by hallmark swollen glands, fever and sore throat.
Edited by April Cashin-Garbutt, BA Hons (Cantab)
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