Glandular fever Flashcards
What is glandular fever?
Term used to describe infectious mononucleosis, a disease caused by the Epstein-barr virus
How does glandular fever present?
Sore throat - worst they have ever had Snoring and sleep apnoea Swollen neck Fever Headache Nausea and vomiting Feeling tired all the time Generalised aches and pains (myalgia and arthralgia)
What is the most common age for glandular fever to occur?
Age 1-6yo
Age 18-22yo
How is EBV spread?
Kissing - saliva
Also rarely stem cell/blood/organ transplant
What is the incubation period of EBV?
6 weeks
Describe examination findings of glandular fever
Enlarged inflamed tonsils - often meet in the middle, kissing tonsils Significant cervical lymphadenopathy Abdominal tenderness and splenomegaly Hepatomegaly Palatal petechiae
What are the differentials for glandular fever?
Tonsillitis
Quinsy
What investigations can be done for glandular fever
Bloods - FBC (elevated lymphocytes), LFT (elevated liver enzymes 2-3 week), Monospot test for EBV (non-specific), more specific ELISA based immunoassays and anti-viral capsid antigen IgG
Describe the management of glandular fever
Symptomatic relief
Penicillin based - benzylpenicillin/penicillin V as bacterial superinfection may also be present
List some complications of glandular fever
Post-viral fatigue Malignancy Guillian-Barre syndrome Encephalitis Splenic rupture
What is the advice about PE at school during glandular fever
Avoid contact sports 4-6 weeks after due to risk of splenic rupture
What does the monospot test for EBV rely on?
Non-specific heterophile IgM autoantibodies
Which cancers is EBV associated with?
Burkitt’s, Hodgkin’s, T cell lymphomas
Nasopharyngeal carcinoma
How long does a glandular fever sore throat last?
7-10 days
