Mononucleosis complications

Overview

Fatalities from mononucleosis are extremely rare in developed nations. However, chronic sub-clinical infection may persist secondary to the dormant virus within the B cells. Reactivation of the virus may occur in susceptible hosts under the appropriate environmental stressors. Similar such reactivation or chronic sub-clinical viral activity in susceptible hosts may trigger multiple host autoimmune diseases and cancers secondary to virus predilection to B lymphocytes and its ability to alter both lymphocyte proliferation and lymphocyte antibody production.

Complications

Rare fatal complications

• Severe hepatitis
• Splenic rupture
• Airway obstruction secondary to adenopathy

Non-fatal complications

Uncommon, non-fatal complications exist, including various forms of CNS and hematological affection.

• Hematological:

• Autoimmune hemolytic anemia indicated by a positive direct Coombs test
• Thrombocytopenia
• Granulocytopenia
• Splenic rupture which may occur without trauma, but impact to the spleen also adds as a contributing factor.

• Neurological:

• Cranial nerve palsies (Bell's palsy)
• Encephalitis
• Meningitis
• Hemiplegia
• Transverse myelitis
• EBV infection has also been proposed as a risk factor for the development of multiple sclerosis(MS) , but this has not been affirmed.

• Cardiology:

• Pericarditis
• Myocarditis

• Hepatology:

• Hepatitis causing elevation of serum bilirubin (in approximately 40% of patients)

References

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