Some people with particularly severe symptoms may need to be looked after in hospital for a few days. Your GP may also recommend a blood test. This can help confirm the diagnosis. It can also help rule out infections that can cause similar symptoms, such as cytomegalovirus CMV , rubella , mumps and toxoplasmosis. This virus is found in the saliva of infected people and can be spread through:. If you have EBV, it's a good idea to take steps to avoid infecting others while you are ill, such as not kissing other people.
Complications associated with glandular fever are not common. However, when they do occur they can be serious see when to seek medical advice above. They can include:. We will not reply to your feedback. Don't include any personal or financial information, for example National Insurance, credit card numbers, or phone numbers.
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Contacts for common benefits are listed below. Call Email dcs. Call Email customerservice. Comments or queries about the Blue Badge scheme can be emailed to bluebadges infrastructure-ni. For queries or advice about claiming compensation due to a road problem, contact DFI Roads claim unit. Where the diagnosis remains unclear, serology is recommended If an initial FBC and heterophile tests fail to indicate glandular fever, specific EBV serology may be requested.
Testing in older adults, children and people who are immunocompromised or pregnant Specific EBV serology and FBC are recommended as the first-line tests for women who are pregnant, people who are immunocompromised, children and older people.
Diagnosis Distinguishing features Cytomegalovirus Pharyngitis, fever, malaise, splenomegaly and lymphadenopathy. May be asymptomatic. Acute HIV infection Symptoms may be less specific and also include mucocutaneous ulceration, rash, headache or diarrhoea. If risk factors are present, HIV should be considered and laboratory testing arranged. Viral hepatitis Fever, abdominal pain, jaundice and malaise. Hepatomegaly is common. Pharyngitis, lymphadenopathy and splenomegaly are less likely.
Toxoplasmosis Fever, lymphadenopathy and rash, but rarely pharyngitis. Transmission is usually via cat faeces or undercooked meat. Human herpes virus-6 More common in young children roseola, sixth disease. Fever of three to five days, widespread rash of macules and papules. The treatment of glandular fever The management of glandular fever includes supportive treatment, identifying patients at immediate risk of complications, and education on the illness and expected symptom duration.
Amoxicillin may cause significant adverse effects Amoxicillin should not be used in people with glandular fever, even where concurrent bacterial infection is suspected. Complications associated with glandular fever The majority of people with glandular fever will have few, if any, long-term complications other than fatigue.
Glandular fever is associated with a risk of splenic rupture Splenic rupture is an extremely rare, but life-threatening complication of glandular fever. Follow-up is usually not required Most people with glandular fever make a full recovery.
References Luzuriaga K, Sullivan J. Infectious mononucleosis. New Engl J Med. Charles P. Aust Fam Phys. Hess R. Routine Epstein-Barr virus diagnostics from the laboratory perspective: still challenging after 35 years. J Clin Microbiol. On the dynamics of acute EBV infection and the pathogenesis of infectious mononucleosis. Available from: www. Editor: Kyle C. A handbook for the interpretation of laboratory tests. Diagnostic Medlab; BMJ Best Practice. BMJ; Viral hepatitis-related acture liver failure.
Am j Gastroenterol. Bell A, Fortune B. What test is the best for diagnosing infectious mononucleosis? J Fam Pract. Epstein-Barr virus infection during pregnancy and the risk of adverse pregnancy outcome. Abdominal pain in acute infectious mononucleosis. National Institute for Health and Clinical Excellence.
NICE, London; Comments There are currently no comments for this article. Make a comment:. Please login to make a comment. This article is 9 years and 1 month old. Social sharing. In this issue A new model for cancer care in New Zealand Following up prostate cancer in primary care Sick and tired of being tired and sick: laboratory investigation of glandular fever.
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Inpractice Recertification programme ». South Link Health South Island general practice support ». SLH Group Practice acquisition and careers in health ». Symptoms may be less specific and also include mucocutaneous ulceration, rash, headache or diarrhoea. Fever, abdominal pain, jaundice and malaise.
Fever, lymphadenopathy and rash, but rarely pharyngitis. Good hand hygiene prevents the virus spreading. Make sure you thoroughly wash your hands regularly. You do not need to be isolated from others, because most people will already be immune to the Epstein-Barr virus. The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.
Liver function tests do not need to be routinely tested. Steroids for symptom control in infectious mononucleosis. Access to the following regional pathways is localised for each region and access is limited to health providers. Looking for Where to get medical help A health professional or service Patient portals Newsletters View all.
Information for healthcare providers on glangular fever The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers. From Sick and tired of being tired and sick: laboratory investigation of glandular fever BPAC, NZ, Liver function tests do not need to be routinely tested. When testing is indicated, the recommended tests are a full blood count FBC and a heterophile antibody test, followed by serology if the diagnosis remains unclear or pregnancy, older or immunocompromised If jaundice or significant hepatomegaly, check liver function tests Throat swabs - a positive throat swab for Strep does not exclude glandular fever.
Regional HealthPathways NZ Access to the following regional pathways is localised for each region and access is limited to health providers. Dr Li-Wern Yim is a travel doctor with a background in general practice.
She studied medicine at the University of Otago, and has a postgraduate diploma in travel medicine Otago.
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