Glandular fever, also known as infectious mononucleosis, or mono, is a viral illness of short duration that affects the tonsils. It is also known as the kissing disease, because the virus that causes it, the Epstein-Barr virus, is transmitted through exposure to saliva and respiratory droplets as in a cough or a sneeze. The virus usually affects adolescents and young adults. The incubation period before symptoms develop can be as long as 50 days after exposure.
Symptoms
The initial symptoms of glandular fever resemble those of the flu, and include weakness, fatigue and fever. Most patients with glandular fever develop fever, pharyngitis, or inflammation of the throat, and adenopathy, or swelling of the glands, particularly those around the neck. Tonsillitis, or swelling and inflammation of the tonsils, is also common. Fatigue can last for months, but is usually worse in the first two weeks of illness. The swelling in the throat and the tonsils can resemble other infections such as strep throat. Inflammation of the spleen is also common, and hepatitis, or inflammation of the liver, can also occur.
Treatment
The treatment of glandular fever is symptomatic, and aims to prevent complications. Fever can be managed with over the counter fever reducers. Hydration is important, especially since the swelling in the tonsils can cause significant pain swallowing and lead to dehydration. In some circumstances, intravenous fluids may be necessary to maintain appropriate hydration. Steroids can be used in people who have such severe swelling of the throat and the lymph nodes of the neck that it causes respiratory difficulty.
Complications
Mononucleosis causes enlargement of the spleen or splenomegaly. This can predispose to splenic rupture, which can lead to severe internal bleeding. To prevent this complication, doctors recommend avoidance of contact sports for about a month after the illness. Hepatitis, or inflammation of the liver, can cause pain in the right upper part of the abdomen, where the liver is located, as well as jaundice, a yellowish tinge to the skin.
Less Common Complications
The tonsils can become infected with bacteria and cause an abscess, or a collection of pus, which may need surgical drainage. The swelling in the tonsils can also result in airway obstruction and the need for mechanical ventilation if the person is unable to breath on his own. Other less common complications include thrombocytopenia, or decreased numbers of platelets, the blood cells in charge of clotting, and inflammation of the brain, or encephalitis.
