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May 1969

Fatal Thrombocytopenia With Cerebral Hemorrhage in Mononucleosis

Author Affiliations

USA, USA, Fort Devens, Mass
From the Fort Devens Army Hospital, Fort Devens, Mass. Dr. Goldstein is now with the Channing Laboratory, Boston City Hospital, Boston, and Dr. Porter is now with the Swedish Hospital, Seattle.

Arch Neurol. 1969;20(5):533-535. doi:10.1001/archneur.1969.00480110097009

ALTHOUGH thrombocytopenia is a common finding in patients with infectious mononucleosis,1,2 severe hemorrhage due to decreased platelets is rare.2-4 Recently weobserved a patient with mononucleosis in whom a cerebral hemorrhage on a thrombocytopenic basis eventuated in death. The uniqueness of this case and the finding of platelet antibodies in the patient's sera prompted this report.

Report of a Case  A 20-year-old man was admitted to the Fort Devens Army Hospital on Feb 16, 1968, following the onset of a petechial rash. During the two weeks prior to admission, he had been seen at the dispensary for complaints of sore throat, fever, malaise, and cough.The illness was considered a viral pharyngitis, and he had been treated with chlorpheniramine maleate, phenylpropanolamine hydrochloride, and isopropamide (Ornade) capsules, cetylpyridinium hydrochloride (Cepacol) lozenges, and aspirin. His past history did not reveal previous abnormal bleeding, and in fact, three months prior to admission, two

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