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Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
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Splenic Infarction in Acute Infectious Mononucleosis
Samuele Naviglio1, Maria Valentina Abate1, Matteo Chinello2
1Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy.
The Journal of Emergency Medicine
|November 26, 2015
Summary
Splenic infarction, a rare infectious mononucleosis complication, can cause abdominal pain. Emergency physicians should consider this diagnosis, even with subtle symptoms, as imaging may be challenging.
Area of Science:
- Emergency Medicine
- Pediatrics
- Hematology
Background:
- Splenic infarction is an uncommon complication of infectious mononucleosis.
- Its pathogenesis is not fully understood but may involve transient prothrombotic factors.
- Evaluating febrile patients with acute abdominal pain is common yet challenging in the emergency department.
Observation:
- A 14-year-old boy presented with fever, sore throat, left upper quadrant abdominal pain, and splenomegaly.
- He had a prolonged activated partial thromboplastin time and a positive lupus anticoagulant.
- Abdominal ultrasonography revealed multiple splenic hypoechoic areas.
Findings:
- Magnetic resonance imaging confirmed spontaneous splenic infarction.
- The patient was admitted for observation and supportive treatment.
- He was discharged in good condition after 7 days.
Implications:
- Spontaneous splenic infarction should be considered in patients with infectious mononucleosis symptoms and left upper quadrant pain.
- Diagnosis can be difficult due to subtle presentations and low sensitivity of initial imaging like abdominal ultrasonography.
- While treatment is supportive, close monitoring for complications is crucial for emergency physicians.
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