Glandular fever: symptoms, causes and which doctor to see

For glandular fever you can first see: Family Medicine or Ear, Nose & Throat (ENT) or Internal Medicine. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: severe sore throat with white-coated tonsils; fever; swollen, tender glands in the neck, especially at the back; marked tiredness lasting for weeks; swollen eyelids; pain in the upper left abdomen (enlarged spleen). Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

Do not play contact sports such as football or basketball in the first weeks; an enlarged spleen can rupture with a blow.

The most common causes: epstein-Barr virus (EBV); spread through saliva: kissing, shared cups and cutlery; less often cytomegalovirus (CMV). Only a doctor’s examination can determine the exact cause.

Fever and sore throat usually settle in 2–3 weeks; tiredness may last several weeks, sometimes months. The illness is usually caught only once.

It is more common in: most often teenagers and young adults aged 15–25, including university students; it also occurs in young children but is usually mild or symptom-free.

The doctor suspects it on examination; a full blood count showing more lymphocytes and atypical lymphocytes, EBV antibody tests or a rapid mono test confirm it. Liver enzymes may rise slightly.

There is no vaccine. Not sharing cups and cutlery and not kissing an ill person reduce spread.

Fever and sore throat usually go within 2–3 weeks; tiredness can last longer.

Both cause a sore throat and coated tonsils. Glands at the back of the neck, marked tiredness and an enlarged spleen are more typical of mononucleosis; blood tests tell them apart.

If the answer to any of these questions is yes, call 112 without delay: “Is there sudden, severe pain in the upper left abdomen?” “Are you struggling to breathe or to swallow your saliva?” “Is there yellowing of the eyes or skin?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: if the sore throat and fever last more than 5 days; if a rash appeared after starting an antibiotic; if tiredness stops you doing daily tasks.