Glandular fever: Symptoms, treatment, causes, and diagnosis

Glandular fever, or infectious mononucleosis, is a common infection among teenagers, young adults, and college students. Symptoms include fever, sore throat, fatigue, and swollen lymph nodes and glands, and sometimes hepatitis.

It is normally caused by the Epstein-Barr virus (EBV) a highly contagious herpes virus. EBV is thought to be present in 90 to 95 percent of people worldwide, but it does not always cause symptoms, and it does not always lead to glandular fever.

There is no cure, and glandular fever usually passes without treatment, but the fatigue can last for some time.

Cytomegalovirurs (CMV) and rubella, or German measles, can also cause glandular fever, but the cause is not EBV and it is not mononucleosis. Toxoplasmosis can cause similar symptoms.

Fast facts on glandular fever:

Here are some key points about glandular fever. More detail is in the main article.

Glandular fever is usually caused by the Epstein-Barr virus (EBV).

EBV is a common herpes virus that many people have, often without symptoms.

Symptoms include a sore throat, fever, swollen glands, and fatigue.

The symptoms may continue for several weeks, and the fatigue may persist for several months.

There is no cure, and glandular fever usually passes without treatment.


Woman holding her throat due to glandular fever
Glandular fever involves swollen lymph glands and a sore throat.

Glandular fever has an incubation period of 4 to 6 weeks. In other words, symptoms appear 4 to 6 weeks after initial infection. The symptoms, and especially fatigue, may continue for several weeks.

They commonly include:

flu-like symptoms, including body aches and a headache

a temperature of 38 degrees Celsius or above

a skin rash that is a widespread, red, and does not itch

nausea and loss of appetite

malaise, fatigue, tiredness, and weakness

swelling and puffiness around the eyes

sore throat

swelling in the lymph glands

swollen spleen, leading to pain in the upper abdomen

liver pain and jaundice

Sore throat

The sore throat may be mild, but it is often very sore, red, and swollen, similar to that of tonsilitis. If a person has severe tonsillitis that lasts longer than usual, this may be glandular fever. Swallowing is often painful.

The lymph glands and the spleen

As the body’s immune system fights the virus, the lymph glands swell. This can affect any lymph node in the body, but the glands in the neck and the armpits are usually the most prominent. They can become swollen and tender.

The spleen is an organ that is part of the immune system. It is found under the ribs on the left side of the abdomen. Like the lymph glands, the spleen can swell, and it can sometimes be felt below the ribs. It may cause mild pain in the upper left section of the abdomen.

The liver

The virus can sometimes cause mild inflammation of the liver, known as hepatitis. It is more common in people over 30 years of age.

Symptoms of hepatitis include:

jaundice, a yellowing of the skin and eyes

intolerance to alcohol

loss of appetite


The symptoms of jaundice and hepatitis should disappear as the person recovers from glandular fever.

The sore throat and fever usually improve after 2 weeks. Fatigue and swollen lymph nodes may persist for longer, sometimes for several months.

People can be infected with EBV but have no symptoms. This is more likely in younger children and in people aged over 40 years.

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There is no cure for glandular fever, and most symptoms normally disappear within 4 to 6 weeks without treatment, although fatigue may persist for up to 6 months in some cases. Most people make a full recovery.

Symptoms can be controlled with:


Complete rest will aid recovery, especially during the first month after symptoms appear. The patient often feels too tired and too unwell to continue with their regular routine. As the person recovers, light exercise may help them regain muscle strength.

Drinking fluids

This will help prevent dehydration, especially if there is a fever. A sore throat can make it hard to swallow, but it is important to consume enough fluid.


Painkillers, such as ibuprofen or Tylenol (paracetamol) can be bought over-the-counter (OTC) or online. They may help control fever and pain. Aspirin is not suitable for anyone under 16 years of age.


Gargling with salt water or a solution from the pharmacy may help relieve a sore throat.


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