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Fatal infectious mononucleosis

Last edited: 4/15/2026

Overview

Fatal infectious mononucleosis, typically caused by Epstein-Barr virus (EBV), rarely progresses to severe complications including encephalitis, hepatitis, and splenic rupture, potentially leading to mortality 1.

Diagnosis

  • Clinical presentation includes fever, sore throat, lymphadenopathy, and atypical lymphocytes 1.
  • Laboratory tests: Elevated white blood cell count with lymphocytosis, positive heterophile antibodies (Monospot test) 1.
  • Imaging and additional tests: Considered if complications suspected (e.g., CT for suspected encephalitis) 1.

    • Management

  • Supportive care: Fluid hydration, pain management, and rest 1.
  • Monitoring: Close observation for signs of severe complications like airway obstruction, sepsis, or organ failure 1.
  • Specific treatments: No antiviral therapy is universally recommended; corticosteroids may be considered for severe complications like airway obstruction 1.

    • Special Populations

  • Pregnancy: Limited data; management focuses on supportive care with close monitoring for maternal and fetal well-being 1.
  • Pediatrics: Increased vigilance for complications such as splenic rupture; avoid contact sports 1.
  • Elderly: Higher risk of severe complications; tailored supportive care and monitoring essential 1.
  • Comorbidities: Patients with underlying conditions require heightened surveillance for exacerbated symptoms 1.

    • Key Recommendations

  • Initiate supportive care measures including hydration and symptomatic relief for fever and pain (Evidence: Moderate 1).
  • Routinely monitor for signs of severe complications such as neurological symptoms or organ dysfunction (Evidence: Moderate 1).
  • Consider corticosteroids for management of severe complications like airway obstruction, though evidence is limited (Evidence: Weak 1).

    • References

    1 Šmídová I. The first Czech perinatal hospice: Joint venture or competitive field?. Health & social care in the community 2022. link

    Original source

    1. [1]
      The first Czech perinatal hospice: Joint venture or competitive field? — Šmídová I Health & social care in the community (2022)
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