Is Mono Dangerous?
Most patients with mono recover without any complications, but some patients (quite rare to develop complications) develop complications and some of these complications can be dangerous. Just the mono infection is not dangerous, but if complications develop it can be dangerous.
- Hematological Complications – Hematological complications are more common in mono. There are several hematological complications such as.
- Thrombocytopenia and granulocytopenia – transient mild thrombocytopenia and granulocytopenia can occur in 50% of cases with mono.
- Hemolytic anemia – Hemolytic anemia occurs in 3% of the patients, it is due to the anti-i-specific cold-agglutinin antibodies and usually resolves in 1-2 months.
- Abnormal lymphocytes
- Aplastic anemia
Neurologic Complications. Neurologic complications are rare (seen in 1.5% of the patients) and usually occur early in the disease, mostly during the first week of the disease. The neurologic complications in mono are-
- Guillain Barre syndrome
- Cranial nerve palsies
- Cerebellar syndrome
Encephalitis is the earliest manifestation with cerebellar dysfunction or it may be global with rapid progression.
Enlarged Spleen And Splenic Rupture. Enlarges spleen occurs in about 75% of patients with mono. Enlarged spleen alone does not complicate things, but there is a chance of splenic rupture due to the splenic enlargement and capsular swelling. The spleen enlargement is maximum between 10-21 days after presentation. Splenic rupture can eb painful, sometimes it occurs without any pain and cause severe hypotension and can even lead to death if not identified initially. To prevent splenic rupture avoid contact sport and heavy lifting for at least 4 weeks after you get sick.
Liver Complications. There can be some liver problems present as well.
Elevated aminotransferase levels – there can be a mild hepatitis and usually this goes away on its own. Aminotransferase levels will be elevated 2 to 3 times of the normal value and it usually returns to the normal level over 3-4 weeks. This is quite a common complication which occurs in about 95% of the patients. If the other enzyme levels elevate and if the jaundice remains other possibilities for hepatitis should be investigated.
Fulminant hepatic disease – a rare complication
Respiratory Complications. Respiratory complications in mono are rare, the complications are.
Upper airway obstruction and difficulty in breathing due to pharyngeal or paratracheal lymphadenopathy – usually respond well to corticosteroids if not responding surgically the tonsils may need to be removed (tonsillectomy).
Interstitial pulmonary infiltrates – these are commonly seen in children and there might not be any clinical features, the only way to diagnose it is with an x-ray.
Pneumonia is a rare respiratory complication.
Cardiac Complications. Cardiac complications such as irregular heart rhythms can occur during the first three months after getting mono. This is usually self-limiting and goes away on its own without any treatment. Other cardiac complications such as myocarditis, pericarditis and ECG changes are very rare.
Ophthalmic Complications. Ophthalmic complications in mono are
Dermatologic Complications. Dermatologic complications in mono are
- Erythema multiforme
Cancers Associated With Mono. If you had mono there is a small increased risk of you getting the following cancers.
Most patients with mono recover without any complications, but some patients (quite rare to develop complications) develop complications and some of these complications can be dangerous. Just the mono infection is not dangerous but if complications develop it can be dangerous. Hematological complications occur most commonly but these are self-limiting except for the rare ones like aplastic anemia, agranulocytosis and pancytopenia. Splenic rupture is a serious complication. Neurological complications such as meningitis, encephalitis, Guillain Barre Syndrome, cerebellar syndrome are rare but serious complications. Respiratory complications such as upper airway obstruction are rare but a serious complication. There is an increased risk of Burkitt’s lymphoma nasopharyngeal carcinoma, and Hodgkin’s lymphoma.
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