In some cases, however, having been exposed to the Epstein-Barr virus (EBV), the main virus responsible for causing mono, can lead to long-term complications and symptoms that persist and, in some cases, even become worse. (3) EBV is a herpesvirus, and it remains in the body once you get it. Typically, it stays completely dormant, or if you do get mono, it stays dormant after causing the initial case of mono. The virus, however, can sometimes be reactivated. That can cause problems for certain individuals, such as those who have weakened immune systems, says Eric Johannsen, MD, an associate professor of infectious diseases and EBV expert at the University of Wisconsin School of Medicine and Public Health in Madison. In these people, symptoms can recur for weeks, months, or years after recovering from the initial mono illness. (4) Here’s what you should know about the complications that can crop up.
Enlarged Spleen Mononucleosis can cause swelling in the spleen, which can raise the risk of a rupture of the organ if too much pressure is applied. This might happen in a fall or from someone bumping into you, which is why doctors recommend avoiding strenuous activity and contact sports while recovering, and often for several weeks after symptoms disappear. A ruptured spleen can cause potentially life-threatening internal bleeding. If you feel a sudden, sharp pain on the left side of your upper abdomen, get medical attention immediately.Fever Hepatitis Some people may experience hepatitis (or liver inflammation). Research suggests as many as 14 percent of people infected with EBV experience some liver enlargement.Jaundice Some people with mono may experience jaundice, which is a yellowing of the skin and the whites around your eyes.Swollen Lymph NodesSwollen Tonsils Breathing may be obstructed. (1,2,5,6,7,8)
Anemia This is a condition when you have a lower red blood cell count than usual.Thrombocytopenia This condition is when you have a low level of blood platelets, the blood cells that are important for helping your blood clot when you’re bleeding.Myocarditis This is an inflammation of the heart muscle.Nervous System Problems These include meningitis, encephalitis, Guillain-Barré syndrome, Bell’s palsy, and seizures.Swollen Testicles Certain Cancers These include Burkitt lymphoma, Hodgkin lymphoma, and nasopharyngeal carcinoma.Multiple Sclerosis Some research has indicated that infectious diseases like mono may be triggers for autoimmune disorders, including multiple sclerosis (MS). Nearly everyone with MS has been infected with EBV, according to Hank Balfour Jr., MD, a professor of laboratory medicine and pathology at the University of Minnesota Medical School in Minneapolis. Doctors are currently exploring the association and working to develop a vaccine for EBV, which they believe may also protect against MS.Post-Transplant Lymphoproliferative Disease These lymphomas can occur after an organ or bone marrow transplant (1,2,4,9,10,11,12)
RELATED: Everything You Need to Know About Lymphoma Additionally, there are certain individuals who may be more likely to develop illnesses related to a mono infection. “Certain populations in Asia and Central America have an increased risk of cancers,” notes Dr. Balfour. (13,14) While doctors aren’t sure what may be behind this elevated risk for developing cancers related to mono, one theory suggests that something in the environment may be to blame, according to Balfour. (3,9,10) There is some evidence that genetics play a role in who is most likely to develop mono (out of those infected with EBV), but whether or not there’s a genetic explanation for who experiences complications from mono is a topic that needs further research. (11,15,16,17) Because certain types of lymphoma are caused by EBV, researchers are also currently exploring this connection to see if the link might help explain what makes certain people more likely to develop EBV complications. (3,4) If you’ve had mono before and are experiencing similar symptoms again, see your doctor to find out what may be causing your illness. You may be experiencing a recurrence of mono, complications that are related to EBV, or another health problem that has symptoms similar to those of mono, such as toxoplasmosis, cytomegalovirus infections, strep throat, or HIV. (2,18)
Difficulty breathingSudden and sharp pain on the upper left side of your abdomen (a sign that you may be experiencing a rupture in your spleen)High fever (101.5 degrees F or higher) that won’t go awayProblems swallowingSevere headacheNoticeable yellow color in eyes and skin (a sign of jaundice)Weakness in the arms and legs (5)
