Glandular Fever (Mono) Symptoms and Signs

Mononucleosis/glandular fever is a severe communicable disease that is caused by the Epstein-Barr virus. Many young adults are infected with mononucleosis because it is called the kissing disease. It is an extremely infectious disease. It has an incubation period from one week to several weeks before the symptoms actually begin to appear.

Mononucleosis/glandular fever classic initial symptoms are:

• Malaise - general ‘sick’ feeling 
• Fatigue-exhaustion 
• Loss of appetite 
• Chills 
• Edema (swelling) of upper eyelids 
• More severe symptoms beginning after initial symptoms dissipate:
• Fever-high body temperature (102 F-104 F) usually accompanied with chills, fast heart rate and a headache 
• Lymphadenopathy - Sore Throat
• Weight loss
• Pharyngeal inflammation - throat inflammation 
• Ulcerated swollen tonsils - red, swollen and painful sometimes with a white coating on them (tonsillitis) 
• Petechiae - little red spots on the skin (rash resembles the measles)
• Vomiting

Older Adults usually will not experience a sore throat, but may experience the following symptoms:

• Jaundice - yellowing of the skin and whites of the eyes (occurs with mild damage to the liver from the disease)
• Hepatomegaly - liver enlargement (occurs with mild liver damage from the disease)

Mononuclosis/glandular fever signs include:

• Lymphadenopathy - enlarged lymph nodes in armpits, groin and neck
• Hepatitis - inflammation of the liver cells
• Splenomegaly - spleen is enlarged
• Hemolytic - red blood cells burst

Some of the more rare symptoms and signs include:

• Splenic rupture - tearing of the spleen
• Upper airway obstruction (difficulty breathing)
• Splenic hemorrhage - excessive bleeding of the spleen 
• Thrombocytopenia - lower platelet levels in the blood, may include pancytopenia - a lower level of all the different kinds of blood cells
• Pneumonitis - lung inflammation
• Pericarditis - heart inflammation
• Erythema multiform - skin redness

Once the initial symptoms have begun to dissipate between one and three days, the more severe symptoms will begin. Most people contact the doctor because of the acute sore throat that is associated with this illness.

In no less than 1/3 of the mono cases the tonsils display a white coating. 
The liver enlarges causing abnormal blood test results. The spleen, considered to be the largest lymph node in the body by some, is located in the upper left abdomen beneath the ribs. It becomes swollen in nearly 50% of mono patients. A red rash resembling measles will appear on about 5 % of the patients with mono.

In some cases, 100% of energy and health levels do not return to normal. Most of the continuous problems usually occur in the glandular fever cases that were extremely harsh or involved some kind of liver problem during the illness. If glandular fever fatigue doesn’t end, this scenario is usually referred to as a (PVFS) post viral fatigue syndrome, otherwise known as (CFS) chronic fatigue syndrome. This syndrome causes extreme exhaustion that is not satisfied with rest. Symptoms may continue here and there for several months, however, some cases do last much longer. If the proper rest is not received during the acute phase of the disease, there is more of a chance for ongoing symptoms to occur. Rest is definitely beneficial when recovering from this disease.