Overview

Glandular fever, also known as infectious mononucleosis, is an illness produced most often by the Epstein–Barr virus. It commonly affects adolescents and young adults but can occur at any age. The condition is characterized by a systemic response to infection and usually resolves without specific antiviral therapy. For basic virology sources see viral infection resources and for information about the causative agent see Epstein–Barr virus.

Typical symptoms and clinical features

Symptoms vary in severity. Common manifestations include:

  • Fever and general malaise
  • Sore throat often with enlarged tonsils
  • Swollen and tender lymph nodes, especially in the neck
  • Marked fatigue that may persist for weeks
  • Occasional enlargement of the spleen or liver

Physical signs and routine blood tests can suggest the diagnosis; specific serological tests are used to confirm EBV infection.

Transmission and prevention

Glandular fever spreads primarily through saliva. Close personal contact such as kissing is a well-known route, which is why the illness is sometimes called the "kissing disease." It can also transmit via shared utensils, toothbrushes or airborne saliva droplets in close settings. General preventive measures include avoiding exchange of saliva, good hand hygiene and not sharing items that contact the mouth. Public health guidance and educational resources are available at relevant health links.

Diagnosis and management

Diagnosis combines clinical assessment with laboratory testing. Heterophile antibody tests (often called Monospot) and specific EBV serology distinguish recent from past infection. Management is supportive: rest, hydration, analgesics or antipyretics, and gradual return to activity. Patients with significant spleen enlargement should avoid contact sports until cleared by a clinician.

Complications, long-term course and notable facts

Most cases resolve uneventfully, but complications can include secondary bacterial throat infection, hepatitis with transient liver enzyme changes, and rarely neurologic or hematologic problems. After primary illness, EBV remains latent in the body and may reactivate without symptoms. In specific contexts and with immune suppression, EBV has been associated with certain rare cancers; such links are complex and depend on additional factors.

History and significance

Epstein–Barr virus was identified in the 1960s and has since been recognized as the main cause of infectious mononucleosis. Glandular fever remains an important clinical diagnosis because of its characteristic symptom pattern, impact on daily activities, and the need for awareness of complications such as splenic enlargement.