Infectious Mononucleosis (Glandular Fever)

Infectious mononucleosis, often called glandular fever, is a viral illness most commonly caused by the Epstein-Barr virus, typically affecting teenagers and young adults. It causes fatigue, sore throat, and swollen lymph nodes, and usually resolves on its own over several weeks.

• Severe sore throat, sometimes with white patches on the tonsils
• Swollen lymph nodes, particularly in the neck
• Fever
• Marked fatigue, which can be prolonged and persist for weeks after other symptoms resolve
• An enlarged spleen in some cases, which carries a small risk of rupture with contact sports or abdominal trauma

• Most commonly caused by the Epstein-Barr virus, though other viruses can cause a similar illness.
• Spread through saliva, often through close contact such as kissing, sharing drinks or utensils, sometimes referred to informally as "the kissing disease."
• Most common in teenagers and young adults, though it can occur at any age.

• Suspected clinically based on the combination of severe sore throat, marked fatigue, and swollen lymph nodes, particularly in a teenager or young adult.
• Blood tests, including a specific antibody test where available, can confirm the diagnosis and help distinguish it from a bacterial throat infection.

There is no specific antiviral treatment; management is supportive with rest, adequate fluids, and paracetamol or ibuprofen for pain and fever.

Gargling with warm salt water can help ease sore throat discomfort.

Contact sports and vigorous physical activity should be avoided for several weeks, particularly if the spleen is enlarged, due to the risk of splenic rupture.

Most people recover fully, though fatigue can be prolonged; medical review is recommended if symptoms are severe, breathing is affected by very swollen tonsils, or recovery is unusually slow.

• Avoid sharing drinks, utensils, or other items that come into contact with saliva.
• Practise good hand hygiene.
• Avoid close contact with someone who has active symptoms where practical, though many people are contagious before symptoms appear.
• Allow adequate rest and avoid contact sports during recovery, particularly if spleen enlargement is confirmed.