Glandular fever (infectious mononucleosis) is an infection carried in the saliva. Some people have no symptoms and young adults more commonly suffer symptomatic glandular fever. Common symptoms include fever, sore throat and swollen lymph nodes. The severity and duration of symptoms varies; a few people develop breathing difficulties due to swelling at the back of the throat and other complications requiring hospitalisation. Symptoms can last for months (it is a risk factor for chronic fatigue syndrome). Symptom relief and rest are commonly recommended treatments.
This review identified four trials that compared the effectiveness of a steroid for short-term symptom control in glandular fever to a placebo and three other trials that used a combination of steroid and a antiviral drug. In total they included 362 participants. Steroid treatment provided relief from sore throat in the short-term (over 12 hours), in combination with an antiviral drug benefit was apparent at two to four days. However, these findings are limited because they were assessed in only one or two trials. Evidence of the effectiveness of steroids for other symptoms of glandular fever, or in combination with an antiviral drug, were less clear. We are unsure of adverse events from using steroids.