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Disseminated Intravascular Coagulation and Hepatic NecrosisComplications of Infectious Mononucleosis
Lawrence L. Pelletier, Jr, MD;
David M. Borel, MD;
Donald A. Romig, MD;
Chien Liu, MD
JAMA. 1976;235(11):1144-1146.
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AN INTRACTABLE bleeding diathesis, disseminated intravascular coagulation (DIC), and infarction of the liver developed in a middle-aged man with infectious mononucleosis. The striking histologic finding in this case was massive coagulative periportal hepatic necrosis.
Report of a Case
A 48-year-old man was admitted to the University of Kansas Medical Center in March 1973, because of somnolence, asterixis, and jaundice. Five weeks earlier he had noted fever, malaise, and pain on swallowing. He then consulted his personal physician, who prescribed saline gargles and ampicillin sodium. Anasarca, dyspnea, and orthopnea developed two days later. A diuretic and dexamethasone sodium phosphate were administered, with resolution of his symptoms. After the discontinuance of dexamethasone therapy, a 40-C (104-F) temperature, sore throat, malaise, and weakness recurred and persisted while the patient continued to receive ampicillin. Progressive jaundice and somnolence developed two days before admission to our institution.
The patient's medical history had been unremarkable. At
. . . [Full Text PDF of this Article]
Author Affiliations
From the departments of medicine and pathology and oncology, Universtiy of Kansas School of Medicine, Kansas City. Dr Pelletier is a senior fellow in medicine, University of Washington, Seattle.
Footnotes
Reprint requests to Department of Medicine, University of Kansas Medical Center, Kansas City, KS 66103 (Dr Liu).
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