CHILD’S HEALTH/INFECTIOUS DISEASES: GLANDULAR FEVER (INFECTIOUS MONONUCLEOSIS)

Posted in General health on May 21st, 2009

Glandular fever is a relatively common viral illness which affects mainly older children and adolescents.

Glandular fever is caused by a virus called the Epstein-Barr virus which is commonly transmitted through saliva (hence its nickname of ‘the kissing disease’).

Clinical features

The incubation period for glandular fever is from 3 days to 2 weeks. The onset of the illness is gradual and at first the child may just feel generally unwell and tired. A fever usually develops, followed by a sore throat and tender, swollen lymph glands. The sore throat tends to continue for a week or two, and does not respond to antibiotics. Occasionally your child may complain of upper abdominal pain due to enlargement of the liver and spleen.

A red, spotty rash may appear on the trunk. Symptoms, especially tiredness or general lethargy, can last for weeks or even months.

It is unusual to see complications with glandular fever, and most children recover completely with time. If the spleen is enlarged, it may be wise to avoid body contact sports, because of the increased risk of rupturing or tearing the spleen (although your child may be too tired to participate in sports). Other complications include hepatitis, meningitis and pneumonia.

Investigations

A blood test which is specific for glandular fever (Monospot) will usually confirm the diagnosis.

Treatment

Glandular fever is a viral illness, so there is no specific treatment or cure. It is unwise to use antibiotics; not only are they ineffective against viruses, but ampicil-lin in particular may cause a nasty rash. Treatment is geared towards the relief of symptoms, such as lowering the fever with paracetamol, and making sure that your child gets plenty of rest and eats well.

When to see your doctor

• if your child has a sore throat that does not improve after 3-4 days;

• if your child complains of extreme tiredness which does not improve after a day or two of rest;

• if your child has any combination of the symptoms described above;

• if you are concerned or have any questions.

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