Introduction
Pfeiffer’s glandular fever, also known as Epstein-Barr virus infection, infectious mononucleosis or “kissing disease”, is caused by an infection with the so-called Epstein-Barr virus. This is a virus from the herpes virus family. In our latitudes, the vast majority of the population, over 95%, is infected with the Epstein-Barr virus by the age of 30.
Mostly, however, children fall ill at a young age. The infection occurs via saliva, for example when kissing, which gave the disease its name “Kissing disease”. An infection with EBV in infancy very often proceeds without symptoms, especially in the case of whistling glandular fever in babies, the symptoms of the disease are rather unspecific.
Infections in adolescents or adults, on the other hand, often show the typical symptoms of mononucleosis. This leads to a feverish inflammation of the throat and tonsils with characteristic coatings, swelling of the lymph nodes throughout the body and a typical change in blood count. The therapy is purely symptomatic, by reducing the fever and relieving the pain. In immunocompromised patients, mononucleosis usually heals without consequences.
Symptoms
The full picture of infectious mononucleosis consists of a mostly generalized swelling of the lymph nodes, whereby the lymph nodes present themselves as mobile and not very painful, a febrile tonsillitis with gray deposits, and a characteristic change in blood count with a sharp increase in leukocytes (white blood cells), which have a high proportion of so-called mononuclear cells. However, this classic constellation of symptoms cannot always be observed. Especially in babies, Pfeiffer’s glandular fever is often difficult to diagnose, as the symptoms that occur are very unspecific and could also be indicative of many other infectious diseases.
The classic symptoms are often accompanied by fever, headache and aching limbs, fatigue and a severe feeling of illness. Roughly speaking, three different forms of the disease can be distinguished. These forms of progression are subdivided according to the main infestation pattern: You can find more information on this topic under: By these symptoms you recognize the Pfeiffer’s glandular fever
- Swelling of the lymph nodes (glandular form)
- Skin rash (exanthematic form)
- Inflammation of the liver (hepatic form)
In the glandular form, which is by far the most common and most characteristic form, a swelling of the lymph nodes is frequently observed throughout the body.
These lymph nodes are mobile and not very painful. Typical places where these lymph node swellings can be palpated are the neck, groin or under the armpits. In addition, the spleen can swell very severely in this form, which in extreme cases can even cause the organ to rupture.
In addition to lymph node swelling and splenic swelling, the above-described tonsillitis with gray deposits can be observed. In addition to the typical features and symptoms of the Pfeiffer’s glandular fever, a skin rash develops in about 3% of cases. Typically, the rash appears on the 4th to 6th day after the onset of the disease.
This rash (a rash is also known as exanthema) is usually fine-spotted and nodular-fine spotted. In addition to the morbilliform (measles-like) rashes, there are also rubeoliform variants, which are reminiscent of rubella. Red wheals (urticaria) can occur as an unspecific reaction of the body.
The typical localization is the trunk of the body, leaving out the extremities and face. However, the rash can also be generalized and spread over the whole body. In addition, severe itching may occur.
In some cases the rash affects the mucous membrane of the hard palate. This is known as petechial enanthema, which appears as the smallest bleeding. On the lateral edge of the tongue there are also often white coatings that cannot be stripped off.
Doctors speak of oral hair leukoplakia. When the liver is affected by glandular fever and the bile pigment bilirubin is no longer absorbed, it is transferred to other tissues and causes the skin of the affected person to turn yellow (icterus). In newborns with a yellowing of the skin, it is important to distinguish them from newborn icterus.Since Pfeiffer’s glandular fever is not a typical disease of the baby with regard to age distribution, a pediatrician should be consulted for further clarification in the case of yellow coloration. A further, rather rare form of the disease also affects the liver. This leads to an inflammation of the liver, also known as hepatitis.
