Complications And Prognosis

Most patients with infectious mononucleosis have the triad of fever, lymphadenopathy, and pharyngitis. The most common complication is swollen tonsils with obstructed

FIGURE 1 Photograph of a patient with mononucleosis shows obstructive tonsillitis.

breathing (Fig. 1) (3). Splenomegaly, palatal petechiae, and hepatomegaly develop in another 10% of infected patients. The main serious complication is enlarged spleen and its possible rupture. Less common complications include hemolytic anemia, thrombocytope-nia, aplastic anemia, myocarditis, hepatitis, rash, and neurologic complications, such as Guillain-Barre syndrome, encephalitis, and meningitis.

Symptoms such as fever and sore throat usually lessen within two to three weeks. Fatigue, enlarged lymph nodes, and swollen spleen may last weeks longer. Most signs and symptoms ease within a few weeks, although two to three months may elapse before patients feel completely normal (4).

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