Pediatrics

You can recognize Pfeiffer's glandular fever by these symptoms

introduction

Pfeiffer's glandular fever has a relatively constant and recognizable course that typically occurs with every initial infection.
Nevertheless, the disease remains inconspicuous for a long time, as it does not differ significantly from a mixed picture of other viral and bacterial diseases. In most cases, the course over time and the typical combination of symptoms ultimately lead the doctor to the correct diagnosis.

Symptoms

Typical symptoms include:

for a long time from general weakness. Those affected often feel tired and more tubed than usual. This weakness begins before the feverish section and continues beyond that.
within the actual or obvious phase of the disease, there is a fever, with temperatures that rise to 38.5 to 39 degrees Celsius.
whitish deposits on the reddened and visibly enlarged tonsils
a swelling of many lymph nodes in the head and neck area. These are then painful to pressure and noticeably enlarged.
In about half of all cases there is a swelling of the spleen, which in the worst case can reach so far that the spleen capsule of the affected person ruptures.
atypical or unspecific symptoms can also occur. These include, for example, a rash and itching

Read more about this: Course of Pfeiffer's glandular fever

Typical symptoms in children

The symptoms already mentioned, with some peculiarities, also occur in children.

within the actual or obvious phase of the illness, there is a fever, with temperatures around 38.5 to 39 degrees. The fever can also be a little less severe in children.
whitish deposits on the reddened and visibly enlarged tonsils
a swelling of many lymph nodes in the head and neck area. These are then painful to pressure and noticeably enlarged.
It is difficult to pinpoint a period of general exhaustion in children. Often it lasts shorter than in adults.
however, the entire list of symptoms may be obsolete, especially with small children. In these cases, the disease is asymptomatic, although there is an infection with the pathogen.

More on this: Glandular glandular fever in the child

Typical symptoms in the chronic form

A characteristic and constant point in the chronic form of the disease is prolonged fatigue. In contrast to the acute infection, where it lasts for a few weeks, most of the chronically ill suffer months later, in extreme cases even years, from this tiredness or fatigue.
In other respects, statements about typical symptoms are unfortunately almost impossible. The chronic form is so multifaceted that the correct diagnosis "chronic Pfeiffer's glandular fever" is often an incidental finding.

Find out more about the topic here: Chronic Pfeiffer's glandular fever

Explanations of the individual symptoms

fatigue

Fatigue is in itself a very unspecific symptom, but typical of Pfeiffer's glandular fever.
Of course, not every person who suffers from increasing tiredness suffers from mononucleosis (the medical name for Pfeiffer's glandular fever). However, the majority of those infected show this symptom.
The tiredness typically lasts for several weeks and occurs as a symptom both before and after the febrile phase of the disease.

For other causes of fatigue, see our main article: Fatigue

Swollen lymph nodes

Swollen lymph nodes that are enlarged and tend to be tender indicate a local, acute activation of the immune system to fight a pathogen.
Mainly the lymph nodes in the neck and face are affected, which can be felt quite easily. Typically there is symmetrical swelling of the lymph nodes.

Further information on this: Lymph node swelling in the neck

Tonsillitis

The swollen, reddened pharyngeal tonsils with a gray-whitish layer are also one of the typical symptoms of mononucleosis.
At the same time, however, this symptom also harbors the risk of mistaking it for another disease. A variety of bacterial diseases is associated with purulent tonsillitis. Treatment with antibiotics is then not indicated in the case of Pfeiffer's glandular fever, as it is a viral disease.

The tonsillitis regresses on its own in Pfeiffer's glandular fever, but it takes a certain amount of time.

You might also be interested in: Causes of tonsillitis

Swollen spleen

This symptom occurs in about half of all those affected. Spleen swelling is a dangerous organ involvement of the disease, as it can grow into a life-threatening situation if the spleen capsule ruptures. If the rupture is recognized too late, massive blood loss can occur due to the very good blood circulation in the spleen. However, this complication occurs very rarely.

Read more about this: Swollen spleen

Increased liver function

In rare cases, the liver can also be affected. Either the pathogen itself can cause the liver cells to be destroyed or blood backs up in the liver, which also leads to the destruction of liver cells.
This process is represented by an increase in liver values from the blood. The measured values are various proteins that only occur in the liver. If the liver cells are destroyed, they get into the bloodstream and can be detected there.

Read more about the topic here: Increased liver values

Rash

A rash is a symptom that is not particularly common in connection with glandular fever. There may be rashes on the torso that cannot be identified. These are reddened and may itch, but do not contain any contagious secretions.
Whether this rash, which has a pronounced trunk, is an allergy or what exactly is the cause has not yet been fully researched.
Furthermore, bleeding the size of a pinhead can occur in the mouth and throat. This picture could possibly be misinterpreted as a rash. The reason for this, however, is an insufficient number of functional blood platelets.

Also read: Rash in Pfeiffer's glandular fever

itching

The itching, together with a skin rash, can indicate that Pfeiffer's glandular fever was mistakenly confused with a bacterial disease.
Some patients react to taking antibiotics for mononucleosis with rashes and itching. In this context, one could speak of an allergic reaction to the antibiotic. This is often the case with treatment with penicillin.
Therefore, self-treatment with medicines available at home should be avoided and a doctor should be consulted in order to avoid such incidents.

You might also be interested in this topic: Rash after antibiotics

Duration of symptoms

A general statement cannot be made about this. Each person is very individual with regard to the duration of the illness, as is the case with other illnesses. In general, however, it can be said that Pfeiffer's glandular fever lasts for a long time compared to other diseases.
However, the phase in which you feel really sick does not usually last longer than two weeks. During this time the noticeable fever, tonsillitis and painful swelling of the lymph nodes appear.
Mononucleosis is known above all for the fact that the disease in its entirety can last a few weeks, as the tiredness or fatigue of those affected can drag on for several weeks. It occurs both before the "actual phase of the disease" and afterwards.

The swelling of the spleen and the increased liver values are also limited to the period of the febrile phase of the illness and usually return to normal afterwards.

How long the symptoms and also the disease generally lasts you can read on our page: Duration of Pfeiffer's glandular fever

Why can the symptoms reactivate?

The Epstein-Barr virus belongs to the group of herpes viruses. Similar to the herpes viruses that cause the "herpes" on the lip or nose, the Epstein-Barr viruses can also persist in the body of those affected.
The viruses implant themselves in the body's own cells and thus manage to hide themselves from the human immune system in a figurative sense. The pathogen is therefore not completely eliminated.
If the immune system is now weakened by other stress factors, the viruses start to multiply in the body again. They are distributed throughout the body and thereby cause reactivation.

I recognize relapse by these symptoms

A relapse or reactivation of Pfeiffer's glandular fever is usually not easily or clearly recognizable. The symptoms are very different. The reactivation can clearly only be achieved by detecting certain virus particles in the blood.
Numerous manifestations are possible, from unspecific abdominal pain to functional disorders of the heart or kidneys. As a rule, reactivation is also accompanied by persistent fatigue.

These symptoms, which can indicate reactivation, are explained below:

Headache, back pain, muscle pain and fever
edema
stomach pain
Night sweats
depression

You may also be interested in this topic: Late sequelae of Pfeiffer's glandular fever

Headache, back pain, muscle pain and fever

Fever, headache, and muscle pain are the three symptoms that most people develop when infected. In all cases, the messenger substances formed by the pathogens are responsible for activating the affected person's immune system.
If the number of active viruses increases again as part of the reactivation, the immune system ensures increased sensitivity to pain as part of the defense reaction and ensures in the brain that the "body setpoint temperature" is raised. This leads to an increase in fever. The muscle pain, which often occurs in the back area, can also occur because components of the viruses are deposited in the muscles.

Edema

Edema can have its origins in either heart or kidney disease. Edema is water retention in body tissue.
Rather, they are a symptom of a cardiological or nephrological problem. If the heart or kidneys are damaged as part of a Pfeiffer glandular fever, which only occurs in rare cases, edema can be an expression of this organ damage.

Also read: Causes of Edema

stomach pain

In rare cases, the Epstein-Barr virus attacks the spleen or liver again when reactivated. If this is the case, this may be the reason for the occurrence of abdominal pain. With the help of an ultrasound examination, the attending physician can then get an idea of the condition or any damage to these organs.
As already mentioned several times, a reactivation can present itself in very different ways. It cannot therefore be ruled out that the viral pathogens can also be responsible for the development of inflammation of the pancreas or intestinal inflammation.

Night sweats

Night sweats can be caused by two things. On the one hand, the "setpoint temperature" increased by pathogen components is throttled again at night. Then, in order to cool down, the body begins to sweat.
A second - but very far-reaching - explanation is based on the fact that it is assumed that Epstein-Barr viruses could play a decisive role in the development of certain types of cancer.
In this context, night sweats are an indication that tumor development has usually already progressed. Night sweats are a typical symptom of tumor diseases and are referred to as "B symptoms" along with fever and unwanted weight loss.

Read about this: B symptoms

depression

What exactly is the connection between the development of depression and the reactivation of mononucleosis has not yet been clarified.
The protracted fatigue that resumes with reactivation seems most likely to be the trigger for the depression. It cannot be ruled out that a physical symptom is wrongly attributed to a psychological cause. So this means that fatigue is seen by doctors as an expression of depression.

Here it goes to: Signs of depression