treatment
Last reviewed 01/2018
- there is no specific treatment available for glandular fever. The reason why some children remain unwell for many weeks, or sometimes many months, is unclear.
- symptoms usually settle in 2-3 weeks (1)
- the mainstay of treatment for infectious mononucleosis includes
- good supportive care
- adequate hydration
- for fever and myalgias:
- nonsteroidal anti-inflammatory drugs(NSAIDs)
- paracetamol / acetaminophen
- to relieve throat discomfort
- throat lozenges
- sprays
- gargling with a 2%lidocaine (Xylocaine) solution
- good supportive care
- advice the patients that:
- exclusion from school is not required for affected children (4)
- vigorous activity should be avoided for at least three to four weeks (until splenomegaly resolves) due to risk of splenic rupture (1)
- drugs not prescribed in IM include
- Ampicillin and amoxycillin should not be used if there is any possibility of EBV infection as they cause a rash. Penicillin is apparently safer (2)
- corticosteroids (3) - except in patients with impending airway obstruction, profound thrombocytopenia, haemolytic anaemia, severe cardiac involvement or neurologic disease (1,3)
- Aciclovir – provides minimal benefit in management of IM (1)
- Urgent medical referral may be required in patients with
- severe or complicated disease
- enlarged tonsils obstructing the airway
- inadequate fluid intake (3)
Reference:
- (1) Pulse 2003. Latest thinking on glandular fever
- (2) Mark H. Ebell. Epstein-Barr Virus Infectious Mononucleosis. Am Fam Physician 2004;70:1279-87,1289-90.
- (3) Charles PGP. Infectious mononucleosis. Australian Family Physician 2003;32(10)
- (4) Health Protection Agency (HPA) 2006. Surrey and Sussex Health Protection Unit – Control of communicable disease in schools and nurseries