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Complications of Infectious Mononucleosis: A Fatal Case in a 2-Year-Old Child

Complications of Infectious Mononucleosis: A Fatal Case in a 2-Year-Old Child Abstract Infectious mononucleosis has been usually considered a benign disease of adolescence and young adulthood. The present paper describes a fatal case of infectious mononucleosis in a 2-year-old boy, whose complications included Reye syndrome. After recovering from the Reye syndrome, he subsequently died from granulocytopenia and septicemia. Other complications included hepatitis, pneumonitis, gingivostomatitis, gastrointestinal bleeding, thrombocytopenia, and an ampicillin rash. The death and complications resulting from this usually benign entity have received little attention in the pediatric literature, and should be recalled by pediatricians confronted with a febrile child. References 1. Filatof NF: Lectures on the Acute Infectious Diseases of Children . Moscow, A. Lang, 1885, vol 1. 2. Pfeiffer E: Drüsenfieber . Jahrbuch F Kinderheilkunde 29:257-264, 1889. 3. Hoagland RJ: The transmission of infectious mononucleosis . Am J Med Sci 229:262-272, 1955.Crossref 4. Fernbach DJ, Starling KA: Infectious mononucleosis . Pediatr Clin North Am 19:957-968, 1972. 5. Evans AS: Infectious mononucleosis in University of Wisconsin students . Am J Hyg 71:342-362, 1960. 6. Starling KA, Fernbach DJ: Infectious mononucleosis in the preschool child . JAMA 203:810, 1968.Crossref 7. Penman HG: Fatal infectious mononucleosis: A critical review . J Clin Pathol 23:765-771, 1970.Crossref 8. Evans A: Infectious mononucleosis: recent developments . Gp 40:127-134, 1969. 9. McMahon JM, Elliott CW, Green RC: Infectious mononucleosis complicated by hepatic coma . Am J Gastroenterol 51:200-207, 1969. 10. Harries JT, Ferguson AW: Fatal infectious mononucleosis with liver failure in two sisters . Arch Dis Child 43:480-485, 1968.Crossref 11. Rahal JJ, Henle G: Infectious mononucleosis and Reye's syndrome: A fatal case with studies for Epstein-Barr virus . Pediatrics 46:776-780, 1970. 12. Reye RDK, Morgan G, Baral J: Encephalopathy and fatty degeneration of the viscera: A disease entity in childhood . Lancet 2:749-752, 1963.Crossref 13. Huttenlocher PR, Schwartz AD, Klatskin G: Reye's syndrome: Ammonia intoxication as a possible factor in the encephalopathy . Pediatrics 43:443-454, 1969. 14. Glick TH, Likosky WH, Levitt LP, et al: Reye's syndrome: An epidemiologic approach . Pediatrics 46:371-376, 1970. 15. Bradford WD, Parker JC: Reye's syndrome . Clin Pediatr 10:148-153, 1971.Crossref 16. Riley HD: Reye's syndrome: J Infect Dis 125:77-81, 1972.Crossref 17. Glasgow AM, Cotton RB, Dhiensieri K: Reye's syndrome: I. Blood ammonia and consideration of the nonhistologic diagnosis . Am J Dis Child 124:827-833, 1972. 18. Schubert WK, Partin JC, Partin JS: Encephalopathy and Fatty Liver , in Popper H, Schaffner F (eds): Progress in Liver Diseases . New York, Grune and Stratton, 1972, vol 5, p 489. 19. Partin JC, Schubert WK, Partin JS: Mitochondrial ultrastructive in Reye's syndrome . N Engl J Med 285:1339-1343, 1971.Crossref 20. Gautier-Smith PC: Neurological complications of glandular fever . Brain 88:323-334, 1965.Crossref 21. Schnell RG, Dyck PJ, Bowie EJW, et al: Infectious mononucleosis: Neurologic and EEG findings . Medicine 45:51-63, 1966.Crossref 22. Ambler M, Stoll J, Tzamaloukas A, et al: Focal encephalitis in infectious mononucleosis . Ann Intern Med 75:579-583, 1971.Crossref 23. Silverstein A, Steinberg G, Nathanson M: Nervous system involvement in infectious mononucleosis . Arch Neurol 26:353-358, 1972.Crossref 24. Huttenlocher PR: Reye's syndrome: Relation of outcome to therapy . J Pediatr 80:845-850, 1972.Crossref 25. Wulff HR: Acute agranulocytosis following infectious mononucleosis . Scand J Haematol 2:179-182, 1965.Crossref 26. Penman HG: Extreme neutropenia in glandular fever . J Clin Pathol 21:48-49, 1968.Crossref 27. Munro AMG, Degnen F, Munro JF: Infectious mononucleosis and agranulocytosis . Scand J Infect Dis 3:249-250, 1971. 28. Fisher BD: Neutropenia in infectious mononucleosis . N Engl J Med 288:633, 1973. 29. Mundy GR: Infectious mononucleosis with pulmonary parenchymal involvement . Br Med J 1:219-220, 1972.Crossref 30. Brown RE, Madge GE: Pulmonary findings in Reye's syndrome . Arch Pathol 92:475-479, 1971. 31. Cassingham RJ: Infectious mononucleosis . Oral Surg 31:610-623, 1971.Crossref 32. Lukes RJ, Cox FH: Clinical and morphologic findings in 30 fatal cases of infectious mononucleosis , abstracted. Am J Pathol 34:586, 1958. 33. Carter RL: Platelet levels in infectious mononucleosis . Blood 25:817-821, 1965. 34. Cantow EF, Kostinas JE: Studies on infectious mononucleosis: III. Platelets . Am J Med Sci 251:664-667, 1966.Crossref 35. Bloom GE, Canales L, Fairchild JM: Thrombocytopenic purpura with infectious mononucleosis . Am J Dis Child 106:415-418, 1963. 36. Radel EG, Schou JB: Thrombocytopenic purpura with infectious mononucleosis . J Pediatr 63:46-60, 1963.Crossref 37. Weary PE, Cole JW III, Hickam LH: Eruptions from ampicillin in patients with infectious mononucleosis . Arch Dermatol 101:86-91, 1970.Crossref 38. Speck WT: High frequency of ampicillin rashed in infectious mononucleosis . Clin Pediatr 10:59-60, 1971.Crossref 39. Gutgesell H: Acute airway obstruction in infectious mononucleosis . Pediatrics 47:141-143, 1971. 40. Rawsthorne G, Cole T, Kyle J: Spontaneous rupture of the spleen in infectious mononucleosis . Br J Surg 57:396-398, 1970.Crossref 41. Einzig M, Neerhaut R: Hemolytic anemia in infectious mononucleosis . Clin Pediatr 8:171-173, 1969.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Complications of Infectious Mononucleosis: A Fatal Case in a 2-Year-Old Child

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References (49)

Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1974.02110270113023
Publisher site
See Article on Publisher Site

Abstract

Abstract Infectious mononucleosis has been usually considered a benign disease of adolescence and young adulthood. The present paper describes a fatal case of infectious mononucleosis in a 2-year-old boy, whose complications included Reye syndrome. After recovering from the Reye syndrome, he subsequently died from granulocytopenia and septicemia. Other complications included hepatitis, pneumonitis, gingivostomatitis, gastrointestinal bleeding, thrombocytopenia, and an ampicillin rash. The death and complications resulting from this usually benign entity have received little attention in the pediatric literature, and should be recalled by pediatricians confronted with a febrile child. References 1. Filatof NF: Lectures on the Acute Infectious Diseases of Children . Moscow, A. Lang, 1885, vol 1. 2. Pfeiffer E: Drüsenfieber . Jahrbuch F Kinderheilkunde 29:257-264, 1889. 3. Hoagland RJ: The transmission of infectious mononucleosis . Am J Med Sci 229:262-272, 1955.Crossref 4. Fernbach DJ, Starling KA: Infectious mononucleosis . Pediatr Clin North Am 19:957-968, 1972. 5. Evans AS: Infectious mononucleosis in University of Wisconsin students . Am J Hyg 71:342-362, 1960. 6. Starling KA, Fernbach DJ: Infectious mononucleosis in the preschool child . JAMA 203:810, 1968.Crossref 7. Penman HG: Fatal infectious mononucleosis: A critical review . J Clin Pathol 23:765-771, 1970.Crossref 8. Evans A: Infectious mononucleosis: recent developments . Gp 40:127-134, 1969. 9. McMahon JM, Elliott CW, Green RC: Infectious mononucleosis complicated by hepatic coma . Am J Gastroenterol 51:200-207, 1969. 10. Harries JT, Ferguson AW: Fatal infectious mononucleosis with liver failure in two sisters . Arch Dis Child 43:480-485, 1968.Crossref 11. Rahal JJ, Henle G: Infectious mononucleosis and Reye's syndrome: A fatal case with studies for Epstein-Barr virus . Pediatrics 46:776-780, 1970. 12. Reye RDK, Morgan G, Baral J: Encephalopathy and fatty degeneration of the viscera: A disease entity in childhood . Lancet 2:749-752, 1963.Crossref 13. Huttenlocher PR, Schwartz AD, Klatskin G: Reye's syndrome: Ammonia intoxication as a possible factor in the encephalopathy . Pediatrics 43:443-454, 1969. 14. Glick TH, Likosky WH, Levitt LP, et al: Reye's syndrome: An epidemiologic approach . Pediatrics 46:371-376, 1970. 15. Bradford WD, Parker JC: Reye's syndrome . Clin Pediatr 10:148-153, 1971.Crossref 16. Riley HD: Reye's syndrome: J Infect Dis 125:77-81, 1972.Crossref 17. Glasgow AM, Cotton RB, Dhiensieri K: Reye's syndrome: I. Blood ammonia and consideration of the nonhistologic diagnosis . Am J Dis Child 124:827-833, 1972. 18. Schubert WK, Partin JC, Partin JS: Encephalopathy and Fatty Liver , in Popper H, Schaffner F (eds): Progress in Liver Diseases . New York, Grune and Stratton, 1972, vol 5, p 489. 19. Partin JC, Schubert WK, Partin JS: Mitochondrial ultrastructive in Reye's syndrome . N Engl J Med 285:1339-1343, 1971.Crossref 20. Gautier-Smith PC: Neurological complications of glandular fever . Brain 88:323-334, 1965.Crossref 21. Schnell RG, Dyck PJ, Bowie EJW, et al: Infectious mononucleosis: Neurologic and EEG findings . Medicine 45:51-63, 1966.Crossref 22. Ambler M, Stoll J, Tzamaloukas A, et al: Focal encephalitis in infectious mononucleosis . Ann Intern Med 75:579-583, 1971.Crossref 23. Silverstein A, Steinberg G, Nathanson M: Nervous system involvement in infectious mononucleosis . Arch Neurol 26:353-358, 1972.Crossref 24. Huttenlocher PR: Reye's syndrome: Relation of outcome to therapy . J Pediatr 80:845-850, 1972.Crossref 25. Wulff HR: Acute agranulocytosis following infectious mononucleosis . Scand J Haematol 2:179-182, 1965.Crossref 26. Penman HG: Extreme neutropenia in glandular fever . J Clin Pathol 21:48-49, 1968.Crossref 27. Munro AMG, Degnen F, Munro JF: Infectious mononucleosis and agranulocytosis . Scand J Infect Dis 3:249-250, 1971. 28. Fisher BD: Neutropenia in infectious mononucleosis . N Engl J Med 288:633, 1973. 29. Mundy GR: Infectious mononucleosis with pulmonary parenchymal involvement . Br Med J 1:219-220, 1972.Crossref 30. Brown RE, Madge GE: Pulmonary findings in Reye's syndrome . Arch Pathol 92:475-479, 1971. 31. Cassingham RJ: Infectious mononucleosis . Oral Surg 31:610-623, 1971.Crossref 32. Lukes RJ, Cox FH: Clinical and morphologic findings in 30 fatal cases of infectious mononucleosis , abstracted. Am J Pathol 34:586, 1958. 33. Carter RL: Platelet levels in infectious mononucleosis . Blood 25:817-821, 1965. 34. Cantow EF, Kostinas JE: Studies on infectious mononucleosis: III. Platelets . Am J Med Sci 251:664-667, 1966.Crossref 35. Bloom GE, Canales L, Fairchild JM: Thrombocytopenic purpura with infectious mononucleosis . Am J Dis Child 106:415-418, 1963. 36. Radel EG, Schou JB: Thrombocytopenic purpura with infectious mononucleosis . J Pediatr 63:46-60, 1963.Crossref 37. Weary PE, Cole JW III, Hickam LH: Eruptions from ampicillin in patients with infectious mononucleosis . Arch Dermatol 101:86-91, 1970.Crossref 38. Speck WT: High frequency of ampicillin rashed in infectious mononucleosis . Clin Pediatr 10:59-60, 1971.Crossref 39. Gutgesell H: Acute airway obstruction in infectious mononucleosis . Pediatrics 47:141-143, 1971. 40. Rawsthorne G, Cole T, Kyle J: Spontaneous rupture of the spleen in infectious mononucleosis . Br J Surg 57:396-398, 1970.Crossref 41. Einzig M, Neerhaut R: Hemolytic anemia in infectious mononucleosis . Clin Pediatr 8:171-173, 1969.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Aug 1, 1974

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