Spontaneous rupture of the spleen masquerading as a pulmonary infection

Atraumatic rupture of a normal spleen represents a rare clinical phenomenon. We report on an atypical presentation of a spontaneous splenic rupture in a 44-year-old previously healthy Greek male admitted to the emergency department due to left-sided pleuritic thoracic pain in the course of a pneumonia diagnosed 2 days before. During his stay, pain extended to the epigastric region. Abdominal examination revealed generalized tenderness. We presume that coughing secondary to respiratory infection was the main factor that precipitated splenic rupture. Despite the rarity of the condition physicians have to consider the diagnosis of spontaneous nontraumatic splenic rupture when they encounter healthy patients with nonspecific lower thoracic or abdominal pain. Prompt diagnosis is essential for a better outcome.