Abstract
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.
Highlights
Infection with Epstein-Barr virus (EBV) has various clinical manifestations
EBV infection is often asymptomatic, in adolescents and young adults, it typically manifests as infectious mononucleosis (IM) with fever, lymphadenopathy, and pharyngitis [1]
Spontaneous splenic rupture secondary to IM was first reported in the literature by King in 1941 [5]
Summary
Infection with Epstein-Barr virus (EBV) has various clinical manifestations. EBV infection is often asymptomatic, in adolescents and young adults, it typically manifests as infectious mononucleosis (IM) with fever, lymphadenopathy, and pharyngitis [1]. The course of the disease is usually benign, approximately 0.1–0.5 percent of patients with IM suffer spontaneous splenic rupture (SSR) [2]. In such cases with hemodynamic instability, splenectomy is the treatment of choice. Hemodynamically stable patients who suffer from parenchymal spleen disruption of pathological substrate can be successfully managed nonoperatively using CT diagnosis, close clinical monitoring, and minimal transfusions [3]. In the case presented consumption of salicylates in high doses might have played a role in the final outcome
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