Glandular fever (infectious mononucleosis or the kissing disease) is a very common viral infection of the lymph nodes (incorrectly called glands) in the neck, armpit, groin and belly that almost invariably occurs in teenagers or in the early twenties. It may occur before puberty when it passes almost unnoticed in a day or two as a mild viral infection.
It is caused by the Epstein-Barr virus (EBV) that is passed from one person to another through the breath. The patient is infectious while they have the tender lymph nodes, and good personal hygiene is important to prevent further spread.
Patients have a sore throat, raised temperature, large lymph nodes in the neck and other parts of the body, extreme tiredness, and generally feel miserable.
The infection and its symptoms usually lasts about four weeks, but in some patients it may persist for several months.
Antibiotics have no effect on this viral infection, and some antibiotics (eg. penicillin) can cause a widespread rash if taken while glandular fever is present. However, some penicillin group medicines may be used if the case is complicated by further bacterial infection.
Complications are very uncommon, but include secondary bacterial infections, infected spleen, or in even rarer cases the liver, heart and brain may be involved.
A specific antibody blood test can prove the diagnosis, but may not turn positive until ten days after the onset of the symptoms. The test is unreliable in children before puberty.
There is no specific cure, and patients must rest as much as possible, take aspirin or paracetamol for the fever and aches, and use gargles for the sore throat. Recurrences are possible in the following year or two at times of stress or lowered resistance.