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December 19, 1959


Author Affiliations

Nashville, Tenn.

From the Department of Medicine, Vanderbilt University School of Medicine.

JAMA. 1959;171(16):2208-2210. doi:10.1001/jama.1959.73010340001013

The occurrence of cutaneous purpura in infectious mononucleosis has been observed for years but was first documented in 1923 by Downey and McKinlay.1 Previously Longcope,2 in 1922, called attention to the abnormal bleeding which often occurred in infectious mononucleosis. Actual thrombocytopenia in infectious mononucleosis was noted by Cottrell.3 The low platelet count in his patient was not accompanied by hemorrhage. The first case of thrombocytopenic purpura complicating infectious mononucleosis was recorded in 1942 by Magner and Brooks.4 Subsequently, at least 23 additional cases of infectious mononucleosis with thrombocytopenic purpura have been described.

Usually, other symptoms of infectious mononucleosis are present prior to the onset of the bleeding phenomena. These include sore throat, malaise, headache, cervical lymphadenopathy, and fever. Thrombocytopenic purpura is an uncommon complication of this disease, but because of the potential danger of cerebral and renal hemorrhage its early recognition is mandatory. This is especially