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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

These have been alluded to in the clinical features but include:

  • gastrointestinal haemorrhage, occurring in 2 to 8%, usually in the third week of the illness. Management is conservative with transfusion and sedation.
  • perforation, occurring only in 3 to 4% but accounting for up to a quarter of deaths. Surgery is the preferred management.
  • jaundice, due to haemolysis, hepatitis, cholecystitis or cholangitis
  • myocarditis, which is a significant cause of death
  • neuropsychiatric complications include delirium, hallucination, paranoid psychoses, with encephalitis, encephalomyelitis, polyneuritis. High dose dexamethasone reduces mortality in severe cases where there are cerebral manifestations or shock.
  • other complications include:
    • haemolytic uraemic syndrome
    • immune complex glomerulonephritis
    • pneumonia
    • pancreatitis
    • abscess formation
    • osteomyelitis

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