Splenic rupture: a rare complication of infectious mononucleosis

Abstract Splenic infarction is a rare complication of infectious mononucleosis. We describe 3 cases of splenic infarction attributed to infectious mononucleosis that we encountered within a 2-month period. We underscore the awareness of this potential complication of infectious mononucleosis and discuss the differential diagnosis of splenic infarction, including infectious etiologies. While symptomatic management is usually sufficient for infectious mononucleosis-associated splenic infarction, close monitoring for other complications, including splenic rupture, is mandated.

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1. Fatal Acute Hepatitis in Infectious Mononucleosis in a Forensic Setting

Medicine Science and the Law ◽

10.1258/rsmmsl.45.3.261 ◽

2005 ◽

Vol 45 (3) ◽

pp. 261-264 ◽

Cited By ~ 2

Author(s):

Anny Sauvageau ◽

Stéphanie Racette

Keyword(s):

Acute Hepatitis ◽

Infectious Mononucleosis ◽

Splenic Rupture ◽

Upper Airway ◽

Neurological Complications ◽

Bleeding Complications ◽

Respiratory Obstruction ◽

First Case ◽

Secondary Infections ◽

Forensic Setting

Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.

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Splenic rupture associated with thrombocytopenic purpura caused by infectious mononucleosis. Case report

Case reports ◽

10.15446/cr.v3n2.62194 ◽

2017 ◽

Vol 3 (2) ◽

pp. 70-76

Author(s):

Alicia Santa Cortes González ◽

Verónica García Torres ◽

Rocío Maily Vázquez Martínez ◽

Uziel Suárez Cruz ◽

Nataly Yazmín Cortés Trujillo

Keyword(s):

Case Report ◽

Infectious Mononucleosis ◽

Splenic Rupture ◽

Thrombocytopenic Purpura ◽

Epstein Barr

Introducción. La rotura esplénica asociada a la presencia de purpura trombocitopénica causada por mononucleosis infecciosa es extremadamente rara; la evolución de los pacientes con mononucleosis infecciosa asociada al virus de Epstein-Barr es benigna y autolimitada y no requiere intervenciones terapéuticas específicas. El cuadro es bien tolerado y tiene una baja frecuencia de complicaciones.Presentación del caso. Paciente femenino de 12 años de edad con dos días de evolución de dolor abdominal difuso, distensión, náuseas, palidez de tegumentos y fiebre no cuantificada, quien a su ingreso al servicio de urgencias muestra datos de descompensación hemodinámica, lesiones purpúricas y manchas equimoticas en extremidades. Se realizan estudios de laboratorio y gabinete que confirman anemia, trombocitopenia y hematoma esplénico, por lo que se practica laparotomía exploradora ante la posibilidad de hemoperitoneo.Resultados. La paciente presenta esplenomegalia, hematoma subcapsular roto con sangrado de 4000mL y lóbulo accesorio de bazo con rotura esplénica.Conclusiones. La rotura espontánea del bazo es una complicación infrecuente pero posible en enfermedades infecciosas; sin embargo su asociación a purpura trombocitopenica es extremadamente rara.

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Case Report: Splenic Infarction in Infectious Mononucleosis due to Epstein–Barr Virus Infection

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0943 ◽

2021 ◽

Author(s):

Hiroaki Nishioka ◽

Katsuma Hayashi ◽

Hayato Shimizu

Keyword(s):

Abdominal Pain ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Rare Complication ◽

Clinical Syndrome ◽

Splenic Infarction ◽

Epstein Barr Virus Infection ◽

Serological Tests ◽

Barr Virus ◽

Epstein Barr

Epstein–Barr virus (EBV) is the most common cause of infectious mononucleosis (IM) and IM is a clinical syndrome typically characterized by fever, pharyngitis, and cervical lymph node enlargement. We describe the case of a 19-year-old man with IM complicated by splenic infarction. The patient visited our hospital because of upper abdominal pain without a fever and sore throat. Abdominal computed tomography revealed a low-density area in the spleen, which indicated splenic infarction. The next day, he developed a fever. After diminishing abdominal pain and fever, he developed pharyngitis accompanied by fever. Acute EBV infection was confirmed by serological tests. The patient was successfully managed with no specific therapy. Splenic infarction is a rare complication of IM and this case showed that splenic infarction can precede a fever and pharyngitis.

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Spontaneous splenic rupture in a patient with infectious mononucleosis

BMJ Case Reports ◽

10.1136/bcr-2019-230259 ◽

2019 ◽

Vol 12 (9) ◽

pp. e230259

Author(s):

Charlotte Ruth Baker ◽

Sid Kona

Keyword(s):

Epstein Barr Virus ◽

Splenic Rupture ◽

Rare Complication ◽

Young Female ◽

Pleuritic Chest Pain ◽

Diagnostic Challenge ◽

Barr Virus ◽

Ebv Infection ◽

Epstein Barr ◽

Atraumatic Splenic Rupture

We present a case of spontaneous, atraumatic splenic rupture secondary to Epstein-Barr virus (EBV) infection, in a young, female patient. Splenic rupture is a rare complication of EBV infection, but is associated with the highest mortality. Additionally, this case illustrates the diagnostic challenge in a patient presenting in atypical manner, with only left-sided pleuritic chest pain, and lacking any of the classical tonsillitis symptoms associated with EBV infection.

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Nonoperative Management of Spontaneous Splenic Rupture in Infectious Mononucleosis: The Role for Emerging Diagnostic and Treatment Modalities

The American Surgeon ◽

10.1177/000313480607200507 ◽

2006 ◽

Vol 72 (5) ◽

pp. 401-404 ◽

Cited By ~ 4

Author(s):

I. Brichkov ◽

L. Cummings ◽

R. Fazylov ◽

J.H. Horovitz

Keyword(s):

Infectious Mononucleosis ◽

Splenic Rupture ◽

Nonoperative Management ◽

Treatment Modalities ◽

Minor Trauma ◽

Spontaneous Splenic Rupture ◽

Traditional Management ◽

Teenagers And Young Adults ◽

Common Manifestation

Infectious mononucleosis (IM) is a self-limiting lymphoproliferative disorder affecting teenagers and young adults. Splenomegaly is a common manifestation of IM and results in a compromised organ that may rarely rupture spontaneously, with significant morbidity and mortality. The IM spleen should be protected from even minor trauma. Although traditional management of spontaneous splenic rupture in IM has been splenectomy, the role of nonoperative management is evolving. The advent of endovascular interventional modalities has augmented the physician's armamentarium in managing these patients nonoperatively. We report a case of spontaneous splenic rupture in a patient with IM managed conservatively with the aid of splenic angiography. The option of arteriography, with or without embolization, should be considered in the management of all patients with spontaneous splenic rupture in the setting of IM.

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Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

Case Reports in Medicine ◽

10.1155/2012/497820 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Konstantinos Bouliaris ◽

Dimos Karangelis ◽

Marios Daskalopoulos ◽

Konstantinos Spanos ◽

Michael Fanariotis ◽

...

Keyword(s):

Hemorrhagic Shock ◽

Infectious Mononucleosis ◽

Potential Role ◽

Splenic Rupture ◽

Emergency Laparotomy ◽

Hemorrhagic Complication ◽

Spontaneous Splenic Rupture ◽

Predisposing Factor ◽

Life Threatening

Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

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