Prognosis

The prognosis for healthy people with IM is very good. Death occurs rarely, and is usually caused by airway obstruction, splenic rupture, neurologic complications, hemorrhage, or secondary infection.

Postinfective chronic fatigue syndrome (CFS)

The reported frequency of this syndrome in patients with history of IM varies in different sources, but overall it is not considered very common. Several small studies raise the possibility that Epstein-Barr virus (EBV) may play some role in the pathogenesis of CFS in subsets of these patients.[76][77][78] No strong data exist to date to routinely implicate EBV an etiologic agent of this highly publicized syndrome.[53] Rather, new evidence suggests that postinfective CFS represents a common and stereotyped outcome from several viral and nonviral infections.[79]

In a longitudinal cohort study, about half of younger patients with CFS after IM with long-term incapacity for work experienced marked improvement, including full-time or part-time employment, thus showing better outcomes than expected.[80]

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