Pfeiffer's Glandular Fever: This viral infection can take a toll on the body for weeks

Pfeiffer’s glandular fever is caused by the Epstein-Barr virus. It belongs to the herpesvirus family and is primarily transmitted through saliva. This is why the disease is colloquially referred to as the “kissing disease.”

After infection, the virus initially multiplies in the throat and then enters specific cells of the immune system. Once the acute phase of the illness has subsided, the virus remains in the body for life. In most cases, however, it remains inactive and does not cause any further symptoms.

According to estimates, most adults are already carriers of the Epstein-Barr virus, often without ever having been aware that they were infected.

The virus is primarily transmitted through close contact with saliva. In addition to kissing, sharing glasses, utensils, or water bottles can also facilitate transmission. Since many people already carry the virus without experiencing any symptoms, infection often goes unnoticed. There is usually a four- to six-week period between infection and the first signs of illness. This comparatively long incubation period often makes it difficult to determine when and where the infection occurred. 

At first, Pfeiffer’s glandular fever often resembles a common viral infection. Only as the illness progresses do typical symptoms develop that may indicate the disease.

The most common symptoms include:

• severe sore throat
• fever
• swollen lymph nodes
• severe fatigue
• Exhaustion
• Difficulty swallowing
• whitish coating on the tonsils
• Headaches and body aches

Many people affected still feel drained even after their fever and sore throat have subsided. This persistent exhaustion can last for several weeks or even months. 

In principle, anyone can develop Pfeiffer’s glandular fever. However, symptoms most commonly first appear between the ages of 15 and 25.

In younger children, on the other hand, the infection often has very mild symptoms or goes completely unnoticed. As a result, it is frequently not recognized at all. Adults usually experience more severe symptoms and often require a longer recovery period. 

In addition to the throat and lymph nodes, other organs may also react to the infection. In many affected individuals, the spleen or liver temporarily enlarges. An enlarged spleen, in particular, warrants attention, as it is more sensitive to external stress.

For this reason, strenuous exercise, heavy lifting, or contact sports should be avoided during the illness and for several weeks afterward. In rare cases, an enlarged spleen can rupture and cause internal bleeding. Severe pain in the upper left abdomen should therefore be evaluated by a doctor immediately. 

The combination of fever, a sore throat, and swollen lymph nodes alone provides important clues to the diagnosis of Pfeiffer’s glandular fever.

To confirm the diagnosis, a blood test is usually performed. This can detect typical changes in white blood cell counts as well as antibodies against the Epstein-Barr virus. In addition, liver function tests are often performed, as liver enzyme levels may be temporarily elevated during the illness. Other conditions, such as bacterial tonsillitis, should be ruled out, as they require different treatment. 

Since Pfeiffer’s glandular fever is caused by a virus, antibiotics are generally ineffective. They are only considered if a bacterial infection is also present.

Certain antibiotics, such as amoxicillin, can even trigger a severe rash in people with Pfeiffer’s glandular fever. Therefore, antibiotic treatment should only be administered after a medical evaluation. Treatment focuses primarily on alleviating symptoms and supporting the body’s recovery. 

The most important measure is physical rest. Getting enough sleep, staying well-hydrated, and eating a balanced diet help the immune system fight the infection. In addition, fever-reducing and pain-relieving medications, as well as gargle solutions or throat lozenges, can alleviate symptoms.

Many people affected by this condition want to return to work or exercise after a few days. However, since the body is often still weakened, physical activity should be increased only gradually. Especially after an enlarged spleen, the treating doctor will decide when exercise is possible again. 

In most cases, Pfeiffer’s glandular fever heals without causing lasting damage, but it takes significantly longer to recover from than many other viral infections. By allowing your body sufficient rest, watching for warning signs, and gradually resuming physical activity, you can support your recovery and significantly reduce the risk of complications.