[A boy with a spontaneous rupture of the spleen; a complication of infectious mononucleosis]

Related Experiment Video

Updated: Jan 21, 2026

Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
08:44

Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis

Published on: September 7, 2022

2.9K

Dineke Ypma1, Constant Coolsma1, Hasan Eker2

  • 1Medisch Centrum Leeuwarden, afd. Spoedeisende Hulp, Leeuwarden.

Nederlands Tijdschrift Voor Geneeskunde
|July 31, 2019
PubMed
Abstract

Insights

Spontaneous splenic rupture, a rare but serious complication of infectious mononucleosis, can occur without trauma. Early recognition in young patients with abdominal pain and pharyngitis is crucial due to potential for rapid deterioration.

Area of Science:

  • Internal Medicine
  • Pediatrics
  • Emergency Medicine

Background:

  • Spontaneous splenic rupture is a rare complication of infectious mononucleosis, occurring in 0.1-0.2% of cases.
  • This condition is associated with significant mortality rates (9-13%) and often occurs without preceding trauma.

Observation:

  • A previously healthy 17-year-old male presented with acute left upper quadrant and shoulder pain, indicative of an acute abdomen.
  • Physical examination revealed pharyngeal exudates, and diagnostic imaging (ultrasound and CT scan) confirmed splenic bleeding.
  • The patient had positive serology for Epstein-Barr virus infection.

Findings:

  • Infectious mononucleosis can lead to spontaneous splenic rupture, even in the absence of trauma.
  • Acute abdomen symptoms and pharyngitis in young patients warrant consideration for splenic rupture.
  • Hemodynamic instability may manifest late in splenic rupture, potentially delaying diagnosis.

Implications:

  • Clinicians should maintain a high index of suspicion for splenic rupture in young patients presenting with acute abdomen and pharyngitis, particularly if they have infectious mononucleosis.
  • Prompt diagnosis and intervention, such as splenic artery embolization, are critical for managing splenic rupture.
  • The potential for delayed shock necessitates vigilant monitoring and rapid management to improve patient outcomes.

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