Overview
Glandular fever, also known as infectious mononucleosis, is characterized by fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis, often caused by the Epstein-Barr virus. 1Diagnosis
Key Diagnostic Criteria: Fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis.
Recommended Tests:
- Lymphocyte-White Blood Cell Count Ratio (L/WCC): Ratio >0.35 suggests glandular fever with high specificity (100%) and sensitivity (90%). 1
- Mononucleosis Spot Test: Used in conjunction with clinical findings and L/WCC ratio for confirmation. 1Management
Supportive Care: Rest, hydration, and symptomatic treatment (e.g., analgesics for fever and sore throat).
Avoidance of Strenuous Activity: To prevent splenic rupture, especially in young adults.
No Antibiotics: Generally not indicated as the condition is viral. 1Special Populations
Pediatrics: Similar management principles apply, with emphasis on monitoring for complications like airway obstruction. 1
Comorbidities: No specific recommendations provided in the abstract; general supportive care remains key. 1Key Recommendations
Utilize the L/WCC ratio as a screening tool with a threshold of >0.35 for diagnosing glandular fever, showing high specificity and sensitivity. (Evidence: Moderate) 1
Avoid prescribing antibiotics for suspected glandular fever due to its viral etiology. (Evidence: Expert opinion) 1
Recommend strict rest and monitoring for potential complications, particularly in pediatric patients and those with splenomegaly risk. (Evidence: Expert opinion) 1References
1 Wolf DM, Friedrichs I, Toma AG. Lymphocyte-white blood cell count ratio: a quickly available screening tool to differentiate acute purulent tonsillitis from glandular fever. Archives of otolaryngology--head & neck surgery 2007. link