Spontaneous Splenic Rupture in Infectious Mononucleosis: Case Report and Review of the Literature

• Published in: Pediatric emergency care Vol. 28; no. 12; pp. 1377 - 1379
• Main Authors: Rinderknecht, Andrea S, Pomerantz, Wendy J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-12-2012; Lippincott Williams & Wilkins
• Subjects: Abdominal Pain - etiology; Adolescent; Air Ambulances; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Aspirin - adverse effects; Aspirin - therapeutic use; Biological and medical sciences; Blood Transfusion; Disseminated Intravascular Coagulation - etiology; Emergencies; Fatal Outcome; Female; Fluid Therapy; Heart Arrest - etiology; Heart Arrest - therapy; Hemoperitoneum - chemically induced; Hemoperitoneum - etiology; Humans; Infectious Mononucleosis - complications; Intensive care medicine; Medical sciences; Nervous system involvement in other diseases. Miscellaneous; Neurology; Resuscitation; Shock, Hemorrhagic - etiology; Splenectomy; Splenic Rupture - etiology; Splenic Rupture - surgery; Vasoconstrictor Agents - therapeutic use; Human; Infection; Case study; Intensive care; Viral disease; Rupture; Child; Infectious mononucleosis; Ultrasound; Resuscitation; spontaneous splenic rupture
• DOI: 10.1097/PEC.0b013e318276c78a
• EISSN: 1535-1815
• ISSN: 0749-5161

ABSTRACTA 15-year-old previously healthy girl presented in full arrest after 1 week of flu-like symptoms, recent diagnosis of infectious mononucleosis, and 1 day of abdominal pain. There was no history of trauma. Focused assessment with sonography for trauma examination showed free fluid in the abdomen. The patient died despite aggressive resuscitative management and emergency laparotomy with splenectomy, which showed grade V splenic laceration. Infectious mononucleosis is a common viral illness of adolescence. Spontaneous splenic rupture is a rare but potentially fatal complication. Anticipatory guidance about the importance of seeking medical care if abdominal pain develops during infectious mononucleosis is crucial to early diagnosis and intervention in the case of rupture. We discuss the current literature surrounding the outpatient follow-up of splenomegaly associated with infectious mononucleosis, as well as current practice and treatment options when rupture occurs.