complications

Last reviewed 01/2018

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