Complications And Consequences Of Infectious Mononucleosis: What Is The Danger Of The Epstein-Barr Virus?

Complications And Consequences Of Infectious Mononucleosis: What Is The Danger Of The Epstein-Barr Virus?
Complications And Consequences Of Infectious Mononucleosis: What Is The Danger Of The Epstein-Barr Virus?

Video: Complications And Consequences Of Infectious Mononucleosis: What Is The Danger Of The Epstein-Barr Virus?

Video: Epstein Barr Virus and Infectious Mononucleosis (pathophysiology, investigations and treatment) 2022, December

The culprit of infectious mononucleosis is a virus from the well-known group of herpes viruses. It is named after the scientists Epstein and Barr. This pathogen is common almost everywhere, and most children meet with it at the age of 3-14 years. Often, the disease proceeds as a mild cold (bacterial acute respiratory disease) or no symptoms at all. The advantages of this condition are lifelong immunity. But this is not always the case. MedAboutMe tells what symptoms the disease has and what complications infectious mononucleosis can cause.

Symptoms of Infectious Mononucleosis: What Does the Virus Do?

If the disease is not mild, then it is remembered for a long time, its manifestations are so pronounced. What is characteristic?

Feverish state with a temperature of up to 38-40 C; Swollen lymph nodes (mainly in the neck); Acute tonsillitis (inflammation of the palatine tonsils, which is sometimes called sore throat); Damage to the liver and spleen.

The disease is long-term, the symptoms are long-lasting. Full recovery can take up to 6 months. During the allocation:

Acute stage, first 2-3 weeks. Recovery - from several weeks to 6 months. On average, 25-35 days after the onset of the disease, the size and function of the liver and spleen normalize. The lymph nodes shrink, but this process can take up to three months. A periodic increase in temperature to 37.5 C is observed up to six months and can be combined with weakness and drowsiness.

During the recovery period, it is very important to continue to observe the child with specialists, undergo examinations, take blood tests for general indicators and biochemical markers, the presence of immunoglobulins and the dynamics of changes in their number.

Complications of infectious mononucleosis

When infectious mononucleosis develops, the virus infects many organs and systems. But there are a number of complications characteristic of this infection that you need to be aware of. Fortunately, they are rare, but they can be quite serious and potentially life-threatening for the child. What do they include?

Ruptured spleen

Due to the increase, pressure on the walls of the organ increases, which, if unfortunate, may end in rupture with massive internal bleeding. The rupture is expressed by sudden sharp pain in the abdomen (stronger on the left), pallor, dizziness, loss of consciousness.

In order to prevent this complication, you cannot go in for sports or go to physical education lessons for at least a month after recovery.

Secondary bacterial infection

During the acute stage, the immune defense is aimed at combating the Epstein-Barr virus, which is dangerous due to the addition of a secondary infection of bacterial etiology. Most often, there are sinusitis, bronchitis, severe tonsillitis.

It is necessary to pay attention to a new wave of fever, exacerbation of sore throat, nasal congestion, increased coughing, worsening of the child's condition.

Labored breathing

Due to excessively enlarged palatine tonsils with infectious mononucleosis or lymph nodes compressing the neck region, the air flow decreases and the child becomes difficult to breathe.

Signs of this condition are noises, wheezing when breathing, shortness of breath, the need for efforts on inhalation and exhalation.


Hepatitis can develop not only due to special hepatitis viruses, but also as a consequence of infectious mononucleosis: the Epstein-Barr virus causes liver damage.If there are signs of jaundice - yellowing of the skin, sclera of the eyes, mucous membranes, and in the blood test there is an increase in liver parameters - urgently see a doctor!


This is a rare but possible complication of the disease in which the lining of the brain is affected. It manifests itself as persistent headache, bouts of nausea, vomiting, convulsions. We need an ambulance team and hospitalization of the child.

Hematologic complications

Due to an inadequate response of the immune system, thrombocytopenia (a low number of platelets in the blood) and anemia (a lack of hemoglobin) may develop.

Decreased immune defenses

The culprit of infectious mononucleosis, the Epstein-Barr virus, is capable of infecting various cells. But it targets mainly the B-lymphocytes of the immune system. This feature leads to immunosuppression, suppression of the body's immune defense function. As a rule, this is a temporary condition, and after 6 months, the links of the immune system return to normal.

If deviations in the blood test persist for a long time, it is worth consulting an allergist-immunologist and assessing the child's immune status.

The consequences of infectious mononucleosis and how to avoid them

After infectious mononucleosis, the Epstein-Barr virus remains with a person forever and, with normal immune function, does not manifest itself. However, if the control of the immune system is reduced, then a chronic condition with low-grade fever, frequent acute respiratory infections, acute respiratory viral infections, mycoses, or even a relapse of mononucleosis in a mild form may develop.

The consequences of the disease that develop against the background of an inadequate response of the immune system include autoimmune diseases - systemic lupus erythematosus, thyroiditis, rheumatoid arthritis, etc.

According to scientific research, there is a correlation between the Epstein-Barr virus and cancer pathologies. These include nasopharyngeal carcinoma, lymphomas. Although this connection is insignificant and the likelihood of pathologies is low.

Expert commentary Alexey Moskalenko, pediatrician

Infectious mononucleosis, despite its widespread prevalence and mainly mild course, is a disease with many possible long-term consequences. In this regard, a child who has undergone a laboratory-confirmed infection must be closely monitored.

A child who has undergone Epstein-Barr Viral infection (EBV infection) should be at least under the supervision of a local pediatrician of the clinic and an infectious disease specialist. Inspections must be carried out once a month.

If there are indications, additional consultations of other narrow specialists are needed: from an otolaryngologist to a hematologist and oncologist. Consultation of narrow specialists is necessary if complications of the disease are found or there is a suspicion of any change on the part of the corresponding organ system.

Within six months or a year (until complete recovery), it is necessary to undergo the following studies:

Detailed blood count; PCR blood test; Serological markers of EBV by ELISA; Immunogram; Oropharyngeal swab.

Additional tests are prescribed when signs of damage to organs and systems appear. For example, a study of the level of liver enzymes for signs of hepatitis.

After the transferred EBV infection, a medical withdrawal from vaccinations and exemption from physical education for 6 months are given. These recommendations should not be neglected, since one of the features of the course of infectious mononucleosis is the presence of hepatolienal syndrome, that is, an increase in the spleen and liver with stretching of their capsules. Increased physical activity (physical education, wrestling, dancing, etc.) can lead to overstretching of an already stretched and thinned capsule, which can cause its rupture. This condition requires urgent surgical intervention.


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