Glandular Fever

Glandular fever, also known as infectious mononucleosis, is most commonly caused by the Epstein-Barr virus (EBV), a member of the herpesvirus family. It is transmitted chiefly through saliva, which is why it is often called the “kissing disease”, and it primarily affects adolescents and young adults. The virus infects B lymphocytes and epithelial cells of the throat, provoking a strong immune response that produces many of the characteristic symptoms.

The illness typically presents with fever, severe sore throat, and markedly swollen lymph nodes, particularly in the neck. Profound fatigue is characteristic and may persist for weeks. Other common features include headache, tonsillar enlargement with exudate, an enlarged spleen, and sometimes an enlarged liver or a skin rash.

Diagnosis is supported by the clinical picture together with a full blood count showing lymphocytosis with atypical lymphocytes, and a heterophile antibody (monospot) test. EBV-specific antibody testing can confirm the diagnosis and distinguish recent from past infection. Liver function tests are often mildly elevated.