BMJ Case Reports 2009; doi:10.1136/bcr.10.2008.1083
  • Unusual presentation of more common disease/injury

Infectious mononucleosis complicated by acute hepatitis and myocarditis: a response to corticosteroids

  1. Robin Ghosal1,
  2. Keir E Lewis1,2,
  3. Sriram Chandramouli1
  1. 1
    Prince Philip Hospital, Respiratory Unit, Bryngwynmawr, Llanelli SA14 8QF, UK
  2. 2
    School of Medicine, University of Swansea, Swansea SA2 8PP, UK
  1. Robin Ghosal, ghosalr{at}
  • Published 23 April 2009


Infectious mononucleosis, or glandular fever, is a viral illness which commonly affects young adults. Symptoms can vary from sore throat, enlarged lymph glands, lethargy and weight loss to more serious clinical manifestations such as myocarditis or hepatitis. Treatment is usually conservative although there has been significant debate over the role of oral corticosteroids, especially in more serious cases. Evidence based medicine suggests that there is little to no role for steroids, but there are enough published case reports where steroid therapy has been potentially life saving that the debate continues. We present a case of a fit and well man who had significant multi-organ involvement secondary to infectious mononucleosis, and our experience of oral corticosteroid treatment.


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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