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Almost everyone goes through it, usually unnoticed — the tiredness afterwards may last weeks.
Also known as: EBV · mononucleosis · glandular fever · mono · kissing disease
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A herpesvirus almost everyone acquires. First infection often presents as mononucleosis (fever, sore throat, swollen nodes, marked fatigue), then stays latent for life. Reactivations are usually harmless. Links to chronic fatigue (ME/CFS) and — with recently strong data — multiple sclerosis are under study.
The spleen is enlarged and can rupture with a knock. That is the most important rule of all — it applies even when one feels fine again.
Certain antibiotics often trigger a widespread rash in this illness. It is not an allergy but it looks like one — and afterwards it often leads to a wrong allergy entry in the record.
Four to eight weeks are normal, in some people longer. Returning in stages rather than all at once — and anyone who takes on full load too early regularly draws the whole thing out.
The throat is strongly swollen for days. Cool drinks, soft food and painkillers before eating keep the amount drunk up — that is the real goal of those days.
Typical first presentation; rest, avoid contact sport due to spleen risk.
Large cohort data support EBV as a necessary precondition for MS — mechanism under study.
Some chronic fatigue begins after EBV; plausible link, not universal.
By adulthood about ninety to ninety-five in a hundred people carry the virus. In childhood it usually passes unnoticed; in teenagers and young adults it appears as glandular fever. The exhaustion afterwards lasts two to six months in some — that is the normal case, not a relapse.
Against Epstein-Barr virus there is no effective drug — antivirals lower the amount of virus in saliva but change nothing about the course. Cortisone is used only if the tonsils obstruct breathing. What matters is what is not given: amoxicillin sets off a rash in a large share of people, which is often taken for an allergy. The spleen needs three to four weeks without contact sport, because it is enlarged and vulnerable.
An exhaustion that goes deeper than in any cold and stays for weeks — often what accompanies people longest.
Severe throat pain with thick coatings, swollen lymph nodes all over the neck — including at the back — and fever that can last more than a week.
A pressure under the left ribs shows the enlarged spleen. Contact sport and heavy lifting are avoided for three to four weeks, because it is delicate during that time.
If the throat infection is taken for bacterial and treated with a penicillin relative, a widespread rash very often follows. That is not an allergy but a pointer to the right diagnosis.
The exhaustion after glandular fever can last months, and the stress axis answers dampened in that time. That is described, but it does not justify giving cortisone — that is used only with a threatened airway.
After the infection a thyroid inflammation occasionally appears: first overactivity, then underactivity, then mostly recovery over months. Anyone left lastingly exhausted after a viral infection has a measurable point here.
In glandular fever the liver is often involved. Alcohol is usually left out for 4–6 weeks until liver values are normal again.
Swollen tonsils make swallowing hard for days. Cool, soft food and drinking in small amounts keep fluid intake going — that is the main thing in the first week.
Widely used in glandular fever, including as an infusion. Controlled studies are lacking; the exhaustion afterwards lasts months in some — and nothing proven changes that.
Recovery takes weeks to months. Returning to sport and work too early is the most common reason for a prolonged course — with an enlarged spleen contact sport is out for 4–6 weeks.
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