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Complications

By Mayo Clinic staff

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Image of enlarged spleen 
Enlarged spleen

Complications of mononucleosis may be more serious than the disease itself.

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
  • Heart problems — an inflammation of the heart muscle (myocarditis)
  • Complications involving the nervous system — meningitis, encephalitis and Guillain-Barre syndrome
  • Swollen tonsils — which can block 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 Aug. 25, 2012.
  2. Infectious mononucleosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec14/ch189/ch189f.html. Accessed Aug. 26, 2012.
  3. Long SS, et al. Long: Principles and Practice of Pediatric Infectious Diseases. 4th ed. Philadelphia, Pa: Elsevier; 2012. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-2702-9..00301-9&isbn=978-1-4377-2702-9&uniqId=353862004-3#4-u1.0-B978-1-4377-2702-9..00301-9. Accessed Aug. 26, 2012.
  4. Pickering LK, et al. Red Book Online. Elk Grove Village, Ill.: American Academy of Pediatrics; 2012. http://aapredbook.aappublications.org. Accessed Aug. 26, 2012.
  5. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Aug. 26, 2012.
DS00352 Dec. 19, 2012

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