GLANDULAR FEVER (INFECTIOUS MONONUCLEOSIS)

INTRODUCTION

Glandular fever is a viral infection caused by the Epstein-Barr virus (EBV), a member of the Herpes Virus family. This infection mostly affects young adults. One attack of the virus will confer lifelong immunity. Most individuals are exposed to EBV in childhood, but the infection is so mild that it often goes unnoticed. When an individual is exposed to EBV in adulthood, however, symptoms of glandular fever arise.

Glandular fever spreads through saliva, as the virus stays and multiplies at the back of the throat. It is spread from one person to another through sharing of utensils, coughing and sneezing, and kissing. Not only is it highly contagious, but is highly resilient too. It can stay in an infected person for upto 18 months after first exposure.

SIGNS AND SYMPTOMS

  • Malaise
  • Flu-like symptoms for several days or weeks, including muscle pain and headache
  • A sore throat
  • Enlarged lymph nodes in the neck, groin, elbows, throat and armpits
  • A high temperature
  • Extreme tiredness
  • A tendency to perspire
  • Yellow jaundice due to enlargement of the liver
  • Stomach pains and signs of an enlarged spleen
  • 10% of cases develop a rash of small, slightly raised spots, which may appear spontaneously or after administration of an antibiotic called ampicillin.

DIAGNOSIS

Diagnosis of EBV is through one or both of the following tests:

  1. Antibody test: It is a blood test that will confirm the presence of the virus in your bloodstream through testing for the antibody against it.
  2. WBC count: increased white cell count in the body will also point towards an active infection, although it is not diagnostic for EBV.

MANAGEMENT

As glandular fever is a viral infection, antibiotics are ineffective against the disease. Because there is no cure as such, treatment is aimed at relieving the symptoms of the disease until the virus runs its course – which normally takes a week or two, although it can take up to a month.

Antibiotics are not effective in treating glandular fever because they have no effect on viral infection. However, antibiotics may be prescribed if you develop a secondary bacterial infection of the throat.

A short course of steroids may also be prescribed if your tonsils are particularly swollen or they are causing breathing difficulties. Steroids are also sometimes used to treat other complications of glandular fever.

COMPLICATIONS

In an estimated 1/100 people, EBV affects the nervous system. It can trigger Guillian-Barre Syndrome (GBS) which a condition which affects the motor neurons of the body, and may cause paralysis of the body, beginning from the lower limbs and ascending upwards. It may also cause secondary viral meningitis in some patients.

Around half the people who are infected with EBV may develop an enlarged spleen. There is a small risk of rupture associated with an enlarged spleen. Symptoms of ruptured spleen include severe, sudden onset right sided abdominal pain. These patients will require emergency surgery for repair.

Approximately 1 in 10 people develop chronic fatigue after EBV infection, which may last for as long as 6-8 months after the infection. This is often referred to as Chronic Fatigue Syndrome.

Research has shown that people with an EBV infection are twice as likely as the general population to develop Multiple Sclerosis later on in life. The reasoning behind this may be the suppression of immune system by EBV which increases the risk of contracting chronic illnesses, and also the genetic make up of individuals which may predispose the persons getting EBV infection could also cause them to be prone to developing MS.

 

Dr. Annie

Physician, mom and wife

One thought on “GLANDULAR FEVER (INFECTIOUS MONONUCLEOSIS)

  • July 3, 2017 at 11:15 am
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    Reply

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