GLANDULAR FEVER: A STUDY OF A HOSPITAL SERIES IN SYDNEY

Acute febrile illnesses resembling glandular fever can result from infection by a number of different microorganisms. A series of 234 patients who were admitted to hospital with the diagnosis of glandular fever confirmed by hæmatological and serological criteria is studied. No significant seasonal variation in the admission rate was found. Estimated on hospital figures, the highest age‐specific attack rates occurred in females in the 15 to 19 years age group, and in males in the 20 to 24 years age group. The mean duration of illness was 25 days and the mean duration of fever was 12·7 days. The most common temperature pattern was a remittent fever with a rise in temperature in the afternoon and evening followed by drenching night sweats. Thirty‐seven per cent of patients had frank jaundice, 85% had abnormal liver function. Other clinical features are mentioned briefly. While moderate leucocytosis was common in the first two or three weeks of illness, peripheral whitecell counts of 35,000/mm 3 occurred in the occasional case. The highest relative mononuclear count was 97%. Heterophil antibodies were detected in the serum in 83% of cases by the twenty‐first day of illness and in 96% by the twenty‐eighth day of illness. The characteristic liver function pattern was a slight rise in the serum bilirubin level, slight, elevation of the SGPT level, and marked increase in the serum alkaline phosphatase level. Twenty‐four patients suffered from serous meningitis, and four from meningo‐encephalitis. All recovered from the encephalitic illness, but one died suddenly from massive pulmonary embolism. The hæmatological complications of haemolysis and thrombocytopenia are discussed. Current work on the Epstein‐Barr virus which appears to be related aetiologically to glandular fever is briefly discussed.