IM健康人群的预后非常好。 极少发生死亡,致死原因通常是气道梗阻、脾破裂、神经系统并发症、大出血或继发感染。
感染后慢性疲劳综合征
对于具有 IM 病史的患者,据报道该综合征的频率因来源不同而各异,但在总体上来说并不常见。 一些小型研究提出,EB 病毒 (EBV) 有可能在这些患者亚群的 CFS 病因中有一些作用。[63]Zhang L, Goudth J, Christmas D, et al. Microbial infections in eight genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). J Clin Pathol. 2010;63:156-164.http://www.ncbi.nlm.nih.gov/pubmed/19955554?tool=bestpractice.com[64]Lerner AM, Beqaj SH, Deeter RG, et al. Valacyclovir treatment in Epstein-Barr virus subset chronic fatigue syndrome: thirty-six months follow-up. In Vivo. 2007;21:707-713.http://www.ncbi.nlm.nih.gov/pubmed/18019402?tool=bestpractice.com[65]Kogelnik AM, Loomis K, Hoegh-Peterson M, et al. Use of valganciclovir with elevated antibody titers against Human herpesvirus-6 (HHV-6) and Epstein-Barr virus (EBV) who were experiencing central nervous system dysfunction including long-standing fatigue. J Clin Virol. 2006;37(suppl 1):S33-S38.http://www.ncbi.nlm.nih.gov/pubmed/17276366?tool=bestpractice.com 至今尚无有力数据表明,EBV 是该广为人知综合征的发病原因。[41]Katz BZ. Update on chronic fatigue syndrome and Epstein-Barr virus. Pediatr Ann. 2002;31:741-744.http://www.ncbi.nlm.nih.gov/pubmed/12455482?tool=bestpractice.com 相反,新证据提示感染后 CFS 表现为多种病毒和非病毒感染作用下的常见、固定的治疗效果。[66]Hickie I, Davenport T, Wakefield D, et al. Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. BMJ. 2006;333:575.http://www.bmj.com/cgi/content/full/333/7568/575http://www.ncbi.nlm.nih.gov/pubmed/16950834?tool=bestpractice.com
在一项纵向队列研究中,约半数长期无法工作(包括全职或兼职工作)的 IM 后 CFS 年轻患者出现明显改善,因此结果比预期更好。[67]Nyland M, Naess H, Birkeland JS, et al. Longitudinal follow-up of employment status in patients with chronic fatigue syndrome after mononucleosis. BMJ Open. 2014;4:e005798.http://bmjopen.bmj.com/content/4/11/e005798.longhttp://www.ncbi.nlm.nih.gov/pubmed/25428629?tool=bestpractice.com