Last reviewed 01/2018

A wide variety of complications may develop including:

  • otitis media - usually in children - and sinusitis - usually in adults
  • myringitis
  • erythema multiforme and Stevens-Johnson syndrome
  • myocarditis and pericarditis
  • myalgia and arthralgia, which may persist for months
  • haemolytic anaemia and renal failure due to the presence of cold agglutinins
  • thrombocytopenia
  • central nervous system problems including meningo- encephalitis, cerebellar ataxia, Guillain-Barre syndrome and transverse myelitis
  • gastrointestinal symptoms, for example diarrhoea, vomiting
  • in patients with sickle cell disease they may trigger a lung crisis

These may occur at any time during the illness and can dominate the clinical picture. Most are rare.