Definition - what is chronic glandular glandular fever?

The chronically active Pfeiffer glandular fever is, as the name suggests, a chronic form of acute Pfeiffer glandular fever, the "infectious mononucleosis". It is defined as the occurrence of disease symptoms even after 3 months after infection with the Ebstein Barr virus.

It is a rare, progressive disease that begins with an acute infection with Pfeiffer's glandular fever. Both adults and children can be affected. The chronically active form of infectious mononucleosis is very rare.

Find out more about the topic here: chronic disease or to the Late sequelae of Pfeiffer's glandular fever

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Causes for a chronification of Pfeiffer's glandular fever

There are some complex circumstances affecting the human body that can cause EBV infection to become chronic. It should be mentioned, for example, that in Germany the infection rate of a previous infection of Pfeiffer's glandular fever is almost the entire population at the age of 40. It means that almost all 40-year-old people in Germany have had an EBV disease in their lifetime to have.

The antibodies, on the other hand, reside in a person's blood for a lifetime in the sense of immune memory. Immunocompromised people often suffer from more severe symptoms than immunocompetent people. The reason for this is that the Epstein Barr Virus attacks certain immune cells that are important for an adequate immune defense.

This means that people with an immune deficiency are more likely to not recover sufficiently from the acute infection or to develop a chronically active form of Pfeiffer's glandular fever. Unfortunately, the exact reasons for a chronification have not yet been found out.

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Chronic glandular glandular fever can be recognized by these symptoms

The symptoms of the chronically active glandular fever are very similar to those of the acute form, even if the chronic form can be somewhat less specific. Most chronically ill people develop a fever with chills and sore throat. The occurrence of pronounced fatigue, concentration problems, difficulties remembering everything and a reduced general condition are variable. In addition, as in the acute form, inflammation of the tonsils and enlargement of the spleen can occur. This can be determined in an ultrasound examination of the abdomen. Furthermore, the liver can become involved with possible yellowing of the skin, the so-called Jaundice, come.

In the foreground of the chronically active form is the restriction of activities due to the pronounced fatigue, which is very stressful for the patient. In addition, it can lead to diffuse pain all over the body. In the chronic form of glandular fever, the symptoms must, according to the definition, persist for more than 3 months.

Read our article about the Late sequelae of Pfeiffer's glandular fever

Diagnosis of chronic glandular fever

The chronically active form of infectious mononucleosis can be diagnosed either through a blood test or through a sample of lymphatic tissue. The laboratory definition states either that the DNA of the Ebstein Barr Virus can be found in the blood or that EBV-positive lymphocytes can be found in the lymphatic tissue of the patient. For this, a tissue sample must be taken from, for example, the tonsils or lymph nodes.

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Blood values ​​in chronic glandular fever

If you have glandular fever, the blood values ​​can provide some important information. So are often already with the acute infection LDH (indicator of cell death) and the transaminases (indicator of liver involvement) increased. In addition, certain antibodies can be detected, the IgM antibodies indicate an active disease and the IgG antibodies show that an infection was experienced in the past.

If a blood smear is made, the examiner can examine the various blood cells in detail. In the event of an illness, you can see more lymphocytes here, which have been changed by the fight against the virus and are similar to monocytes. That is why it is also called "Infectious mononucleosis". The examination of the virus DNA in the blood and the duration of the disease of over 3 months are groundbreaking for the diagnosis of a chronically active form. IgG is increased and IgM can be elevated or normal.

The chronic fatigue syndrome

The chronic fatigue syndrome is a complex clinical picture, which is characterized by extreme tiredness and cannot yet be explained by an organic cause. It is often brought in connection with Pfeiffer's glandular fever. Symptomatic illness with glandular fever is often seen as pronounced physical weakness and fatigue, which can persist for several weeks even after the other symptoms have healed. With chronic fatigue syndrome, the performance of everyday activities is restricted and bed rest does not improve the general condition.

Treatment of chronic glandular fever

Basically, in the treatment of Pfeiffer's glandular fever, the improvement and alleviation of symptoms are in the foreground.

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  • Physical protection should be observed.
  • For severe pain and fever, you can use pain relievers like Ibuprofen and Aspirin® or other antipyretic pain relievers like Paracetamol help.
  • The sick person is at risk of losing a lot of fluid due to the fever and the defense processes in the body. Therefore, care must be taken to drink enough.
  • Ampicillin should not be given for sore throats because there is a viral infection and some antibiotics in the Epstein Barr virus cause a rash.

More information is available here: Treatment of Pfeiffer's glandular fever

The therapy of the chronically active glandular fever is currently not yet adequately proven by clinical studies. Some medical professionals will Acyclovir recommended an antiviral drug that stops the virus from multiplying. Also is Interleukin 2 in conversation, which is a tissue hormone that is part of the human immune system. In individual cases, a stem cell transplant has led to healing.

In summary, it can be said that there is still no established form of therapy for the chronically active form of Pfeiffer's glandular fever and that a decision must be made in individual cases depending on the patient's condition.

You might also be interested in: Chronically ill - what to do?

Homeopathy for chronic glandular fever

The holistic therapeutic approach of homeopathy has been concerned with possible improvements for the symptoms of a chronically active Epstein-Barr virus infection for years. Here, diluted active ingredients are used to try to get the body's regulatory processes going and to support the healing process. The aim is to maintain a change in the cells and organs of the body by strengthening the immune system. If you are interested in naturopathic therapy, you can go to a homeopathic practice.

More information can be found here: Homeopathy for glandular fever

Duration / forecast

Since the chronically active form of Pfeiffer's glandular fever is very rare, no general statement can be made about the duration or prognosis of the disease. Basically, the symptoms must have persisted for more than 3 months in order for the prerequisites for a chronic disease to exist. The duration of the symptoms varies depending on the individual condition and response to therapy. The prognosis of the disease depends mainly on complications that may arise.

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When can you do sports again?

In principle, it is also important when resuming sporting activities that the overall condition of each patient is assessed individually and the decision is made accordingly. If the spleen has enlarged, it is important to take care of the body until the normal size of the spleen is measured by the doctor in the ultrasound.

Concerning the blood count, the viral load in particular should be examined and sport should only be resumed when the virus DNA can no longer be detected. Excessive exertion can put too much strain on the immune system and disrupt the healing process.

It is also advisable to wait for the blood count and liver values ​​to normalize.


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