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Complications

By Mayo Clinic staff

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Illustration showing enlarged spleen 
Enlarged spleen

Enlargement of the spleen
Mononucleosis may cause enlargement of the spleen. In extreme cases, your spleen may rupture, causing sharp, sudden pain in the left side of your upper abdomen. If such pain occurs, seek medical attention immediately — you may need surgery.

Liver issues
Problems with your liver also may occur:

  • Hepatitis. You may experience mild liver inflammation (hepatitis).
  • Jaundice. A yellowing of your skin and the whites of your eyes (jaundice) also occurs occasionally.

Less common complications
Mononucleosis can also result in the following less common complications:

  • Anemia — a decrease in red blood cells and in hemoglobin, an iron-rich protein in red blood cells
  • Thrombocytopenia — low count of platelets, which are blood cells involved in clotting
  • Inflammation of the heart
  • Complications involving the nervous system (meningitis, encephalitis, Guillain-Barre syndrome)
  • Swollen tonsils, leading to obstructed breathing

The Epstein-Barr virus can cause much more serious illness in people who have impaired immune systems, such as people with HIV/AIDS or people taking drugs to suppress immunity after an organ transplant.

References
  1. Epstein-Barr virus and infectious mononucleosis. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/diseases/ebv.htm. Accessed April 27, 2010.
  2. Infectious mononucleosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec14/ch189/ch189f.html. Accessed April 27, 2010.
  3. Fort GG, et al. Mononucleosis. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/198193047-5/0/2088/420.html#4-u1.0-B978-0-323-05609-0..00022-8--sc0150_8624. Accessed April 27, 2010.
  4. Katz BZ. Epstein-Barr virus infections (mononucleosis and lymphoproliferative disorders). In: Long SS, et al., eds. Long: Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/198193047-5/0/1679/211.html?tocnode=55243816&fromURL=211.html#4-u1.0-B978-0-443-06687-0..50210-1_3825. Accessed April 27, 2010.
  5. Ross SM. An integrative approach to rhinosinusitis in children. Holistic Nursing Practice. 2009;23:302.
  6. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2010.
DS00352 June 26, 2010

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