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Mononucleosis (cont.)

Outlook

Mononucleosis is generally a self-limited disease that runs its course, and the infection typically goes away in two to four weeks. More than 95% of people recover normally without any permanent health consequences.

Complications are uncommon but may be life-threatening. Death from mononucleosis is very rare and most often occurs if the spleen ruptures.

The spleen (which is an organ that is actually like a big lymph node) ruptures in about 0.5% of people with mononucleosis. Approximately 90% of these cases occur in males. Rupture usually occurs during the second or third week of the illness when individuals start to feel better and they resume strenuous activities. If the spleen ruptures, doctors may need to surgically remove it.

Airway obstruction occurs in one out of every 100-1,000 cases of mononucleosis. It may occur at any age, but it is more common in young children. Corticosteroids may be used to treat this complication.

Autoimmune hemolytic anemia (a condition in which the body destroys its own red blood cells) occurs in 1%-3% of people with mononucleosis. It usually becomes clinically apparent during the second or third week of illness. Corticosteroids may be used to treat this complication.

Thrombocytopenia, which is a decrease in platelets in the blood, has been noted in up to 50% of people with mononucleosis. It is usually mild and not life-threatening. If severe, corticosteroids may be used to treat this complication.

Hepatitis caused by the Epstein-Barr virus occurs in 80%-90% of people with mononucleosis. This condition is usually mild and goes away by itself.

Neurologic complications may occur, although rarely. These might include seizures, Guillain-Barré syndrome, Bell's palsy, transverse myelitis, encephalitis, meningitis, and cranial nerve palsies. Corticosteroids may be used to treat these complications.