Complications of Infectious Mononucleosis

Glandular Fever Encephalitis

“…However, they may precede the usual signs, which are often minimal or, as in this case, absent (Erwin et al, 1959). As the Paul-Bunnell test is usually positive in cases with complications (Evans, 1960), it should be performed routinely in patients with meningoencephalitis of doubtful origin.…”

“…Only about 1% of cases develop this complication, but frequent reports have shown that a wide variety of neurological lesions may occur (Bergin, 1960). Serous meningitis and polyneuritis are two of the commoner manifestations, while permanent paralyses and death from respiratory failure are on record (Erwin et al, 1959). About 60 cases of encephalitis have been reported, many of which also showed a meningeal reaction.…”

“…About 60 cases of encephalitis have been reported, many of which also showed a meningeal reaction. The mortality rate in cases with neurological involvement is estimated at between 15 and 40% (Erwin et al, 1959), and in one series 43% of deaths from glandular fever were due to this cause (Lawrence, 1951). Corticosteroid therapy has been used with apparent benefit in these serious cases (Fiese et al, 1953 ;Hughes and Paulley, 1960;Stillerman and Peltz, 1960).…”

Involvement of Anterior Horn of Spinal Cord in Infectious Mononucleosis

“…Hoagland (1960), reporting his experience of 200 cases, mentioned only two with neurological complications. Though in the past paralysis of muscles due to involvement of peripheral spinal nerves has been reported by Richardson (1942), Saksena (1943), and Erwin et al (1959), paralysis due to a lesion of the anterior horn of the spinal cord has not hitherto been reported. The following case report describes this unusual complication of infectious mononucleosis.…”

Rupture of the Spleen in Infectious Mononucleosis

“…Rupture of the spleen usually presents as abdominal pain complicating a known case of mononucleosis or of persistent sore throat (Davidson, 1958), for it takes about two weeks for the pathological changes in the spleen which cause it to rupture to come about. These changes have been described (Erwin et al, 1959) as an infiltration of the capsule with lymphocytes and monocytes, increase in bulk of the splenic pulp, and blurring of the normal architectural pattern. However, as the following case shows, the presentation may be as an acute abdominal emergency.…”