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.

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)