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Glandular Fever Testing in Patients Presenting With Tonsillitis: A Retrospective Study
Abubaker Elamin1,2, Amena Al Saad3,4, Laith Sinan5
1General Surgery, Humanitas University, Milan, ITA.
Cureus
|December 11, 2023
Summary
Many glandular fever (Epstein-Barr virus) cases are misdiagnosed as simple tonsillitis. Early screening for Epstein-Barr virus is crucial to prevent serious complications associated with this infection.
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- Tonsillitis, common in school-aged children, is often caused by viral or bacterial infections.
- Glandular fever, a severe form of tonsillitis, is caused by the Epstein-Barr virus (EBV).
- EBV infection can lead to serious complications like splenic rupture and encephalitis, necessitating early detection.
Purpose of the Study:
- To identify the number of glandular fever cases misdiagnosed as simple tonsillitis.
- To highlight management considerations for patients with potential EBV infection.
Main Methods:
- A 12-month retrospective cohort study at Lincoln County Hospital.
- Inclusion of 185 patients diagnosed with tonsillitis.
- Review of presenting symptoms, liver function tests, and EBV screening results.
Main Results:
- Out of 112 screened patients, 35 (31.3%) tested positive for EBV.
- Abnormal liver function tests were observed in 74% of EBV-positive patients.
- An estimated 23 additional EBV cases (12% of the total) may have been missed.
Conclusions:
- A significant proportion of EBV infections may be undiagnosed, presenting as simple tonsillitis.
- The high rate of missed cases underscores the importance of EBV screening.
- Prompt identification and management are vital to mitigate EBV-related complications.
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