Infection: Glandular Fever

Question 1

What is another term for glandular fever?

Answer 1

Infectious mononucleosis

Question 2

What is the causative agent?

Answer 2

Epstein-Barr virus

Question 3

EBV is also involved in the pathogenesis of what other conditions?

Answer 3

Burkitt’s lymphoma
Lymphoproliferative disease in immunocompromised host
Nasopharyngeal carcinoma

Question 4

How is it transmitted?

Answer 4

Usually by oral contact

Question 5

Older children and occasionally younger, may develop a syndrome with what characteristics?

Answer 5

Fever
Malaise
Tonsillitis/pharyngitis - often severe 
Lymphadenopathy- prominent cervical lymph nodes
Petichiae on soft palate 
Hepatosplenomegaly 
Maculopapular rash 
Jaundice

Question 6

Diagnosis is supported by what investigations?

Answer 6

Atypical lymphocytes - numerous large T cells on blood film
Positive monospot test
Antibodies - viral capsid antibodies and EB nuclear antigen antibodies

Question 7

How long can symptoms last?

Answer 7

1 to 3 months

Question 8

What is often a prominent feature in adolescents?

Answer 8

Fatigue

Question 9

What antibiotics should be avoided?

Answer 9

Amoxicillin and ampicillin - cause a florid maculopapular rash in children infected with EBV

Question 10

How is it treated?

Answer 10

Conservative: fluids, rest, analgesia

If airway compromised - corticosteroids can be considered