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