---
title: "Glandular fever: Symptoms & Treatment | HealthAnswers"
description: "Glandular fever (infectious mononucleosis) — symptoms, how long it lasts, swollen glands, fatigue, and when to avoid contact sports."
url: https://healthanswers.co.uk/conditions/glandular-fever/
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---

# Glandular fever: Symptoms & Treatment | HealthAnswers

Health A–Z

Glandular fever (infectious mononucleosis) — symptoms, how long it lasts, swollen glands, fatigue, and when to avoid contact sports.

Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026

## Quick answer

What is glandular fever? Glandular fever is a viral infection usually caused by Epstein-Barr virus (EBV), common in teenagers and young adults. It causes severe sore throat, swollen neck glands, fever, and fatigue that can last weeks to months. Most people recover fully without specific treatment — rest, fluids, and paracetamol or ibuprofen. Avoid contact sports for at least 4 weeks because of spleen enlargement risk.

## Who is this page for?

This page is for people in the UK who want a plain-English overview of Glandular fever, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally.

## Who should skip this page?

Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland.

On this page 10 sections

## Key facts about glandular fever

- Most cases are caused by Epstein-Barr virus (EBV) — spread through saliva.
- Classic triad — severe sore throat, marked neck gland swelling, and profound fatigue.
- Diagnosed with blood test (Monospot or EBV serology) when clinical suspicion is high.
- Amoxicillin and ampicillin cause a rash if given before EBV is ruled out — avoid if glandular fever suspected.
- Avoid rugby, football, and contact sports for at least 4 weeks due to enlarged spleen rupture risk.

## Glandular fever — infectious mononucleosis

**Glandular fever** (medically **infectious mononucleosis**, often called **mono**) is a viral illness most commonly caused by **Epstein-Barr virus (EBV)**. It is especially common in **teenagers and young adults** — though many people catch EBV earlier in life with mild symptoms or none at all.

The illness is famous for **severe tiredness** that outlasts the sore throat — recovery is often measured in **weeks to months**, not days.

## Symptoms

**Typical presentation:**

- severe sore throat — can mimic bacterial tonsillitis

- swollen lymph nodes — especially neck; may be armpits and groin too

- high temperature and flu-like aches

- profound fatigue — often the most disabling symptom

- swollen, puffy eyelids sometimes

- headache , loss of appetite

**Less common:**

- rash — especially if given amoxicillin or ampicillin before diagnosis

- jaundice — mild liver involvement (yellow skin/eyes)

- enlarged spleen — felt as fullness left upper abdomen

- enlarged liver

**Not everyone gets all symptoms** — some have mild sore throat and fatigue only.

## How it spreads

EBV spreads through **saliva**:

- kissing

- sharing drinks, cups, or cutlery

- coughs and sneezes (less than flu)

The virus has a long incubation period — **4 to 6 weeks** from exposure to symptoms.

You are **most infectious** when acutely unwell, but the virus can be shed for months — reason to avoid sharing utensils while ill.

## Diagnosis

GP may diagnose clinically in a young person with classic features. **Blood tests** confirm:

- Monospot test — rapid but can be false negative early

- EBV serology — IgM and IgG antibodies

**Full blood count** often shows **atypical lymphocytes** — characteristic white cell pattern.

**Throat swab** may be done to exclude **strep throat** — glandular fever is viral, so antibiotics do not cure it (except the rash issue below).

## Treatment — supportive care

**No antiviral cure** for EBV in otherwise healthy people. Treatment is:

- rest — listen to fatigue; do not push through

- fluids — prevent dehydration, especially if swallowing is painful

- paracetamol or ibuprofen — fever, pain, throat inflammation

- throat lozenges, warm drinks, ice lollies — comfort

- avoid alcohol — liver is often inflamed

**Steroids** — occasionally used for severe airway swelling — specialist decision only.

**Do not take amoxicillin or ampicillin** if glandular fever is suspected or confirmed — causes widespread rash in most EBV cases.

## Complications — rare but important

| Complication | Notes |
| --- | --- |
| Splenic rupture | Life-threatening — avoid contact sport; seek emergency care for sudden severe left-sided abdominal pain |
| Airway obstruction | Massive tonsil swelling — rare; may need steroids or hospital |
| Severe hepatitis | Uncommon |
| Chronic fatigue | Post-viral fatigue syndrome in some — overlaps with long recovery |
| Secondary bacterial infection | Tonsillar bacterial superinfection — rare |

## Sport and exercise — critical advice

**Enlarged spleen** is common and not always obvious on examination.

**Avoid for at least 4 weeks from onset:**

- rugby, football, martial arts, boxing

- heavy weightlifting

- any activity with abdominal trauma risk

Return to sport only when GP confirms spleen has returned to normal size if previously enlarged.

## Glandular fever vs other illnesses

| Condition | How it differs |
| --- | --- |
| Strep tonsillitis | Often no marked fatigue; responds to antibiotics; no EBV rash with amoxicillin |
| COVID-19 / flu | Different pattern; test if suspected |
| Cytomegalovirus (CMV) | Similar mono-like illness — blood tests distinguish |
| HIV acute seroconversion | Mono-like illness — HIV test if risk factors |
| Lymphoma | Persistent painless nodes, night sweats, weight loss — GP excludes if doubt |

See our [swollen glands](https://healthanswers.co.uk/symptoms/swollen-glands/) guide if nodes persist beyond expected recovery.

## Recovery timeline

**Week 1 to 2:** Peak symptoms — throat, fever, glands.

**Week 2 to 4:** Throat and fever usually improve; **fatigue often worsens or plateaus**.

**Month 2 to 6:** Gradual energy return — non-linear; good days and bad days.

**Return to normal:** Most fully recover within **2 to 3 months**; a minority have fatigue longer — worth GP review if not improving by 4 months.

## Practical tips

- University/work — explain illness; phased return beats crashing and relapsing

- Do not kiss or share utensils while acutely infectious

- Avoid alcohol until liver tests normal if jaundice occurred

- Sleep — fatigue is physiological, not laziness

Glandular fever is miserable but **almost always self-limiting** in healthy young people. Patience with fatigue, avoiding contact sport, and not taking inappropriate antibiotics are the keys to safe recovery.

## ! When to see a GP about glandular fever

See a GP if you have a severe sore throat lasting more than a week, very swollen glands, persistent high fever, or exhaustion preventing normal activity — especially aged 15 to 25. Seek urgent help for difficulty breathing or swallowing, severe abdominal pain (possible spleen rupture), or yellowing of eyes and skin (jaundice). Most cases can be managed at home once diagnosed.

## Common questions about glandular fever

How long does glandular fever last? Acute symptoms — sore throat, fever, swollen glands — usually improve over 2 to 4 weeks. Fatigue and tiredness often persist for weeks to months — sometimes up to 6 months — even after other symptoms resolve. Gradual return to normal activity is advised; rushing back often worsens fatigue. Is glandular fever the same as mono? Yes — infectious mononucleosis (mono) is the medical name; glandular fever is the common UK term. Both refer to the same illness, usually caused by Epstein-Barr virus. How do you catch glandular fever? Mainly through saliva — kissing (hence "kissing disease"), sharing cups or utensils, or coughs and sneezes. EBV is very common — many people are infected in childhood with mild or no symptoms. Teenagers and young adults more often get full glandular fever symptoms. Can you get glandular fever twice? Very rarely — EBV usually causes lifelong immunity after first infection. Fatigue relapses months later are common but are not reinfection — post-viral fatigue is part of recovery. Other viruses can cause similar illness. Why should you avoid sport with glandular fever? EBV enlarges the spleen — contact to the abdomen during sport can cause splenic rupture, a life-threatening bleed. Avoid contact sports, heavy lifting, and strenuous exercise for at least 4 weeks, longer if the spleen is still enlarged on examination. What is the glandular fever rash? A widespread red rash can occur if amoxicillin or ampicillin is given for presumed bacterial tonsillitis before EBV is diagnosed — not an allergic reaction in the usual sense but a characteristic interaction. Tell any doctor you have or may have glandular fever before taking antibiotics. Can glandular fever cause liver problems? Mild liver inflammation is common — slightly raised liver enzymes, sometimes mild jaundice. Usually resolves with recovery. Avoid alcohol while unwell. Severe hepatitis is rare. When can I return to school or work? When fever has gone and you feel able — often after 1 to 2 weeks for desk work or study. Physical jobs and sport need longer. Fatigue may limit full capacity for weeks — phased return helps.

## Sources

- [NHS — Glandular fever](https://www.nhs.uk/conditions/glandular-fever/)
- [NICE — Sore throat and glandular fever](https://www.nice.org.uk/guidance/ng84)