Splenic Infarction as a Complication of Acute Epstein-Barr Virus Infection in an 18-Year-Old Woman

Infectious mononucleosis, caused by Epstein-Barr virus (EBV), is a common illness in adolescents and young adults that usually follows a benign, self-limiting course. We report the case of an otherwise healthy 18-year-old woman who developed a radiologically confirmed splenic infarct presenting with left upper quadrant abdominal pain as a rare complication of infectious mononucleosis. Imaging demonstrated splenomegaly with a subcapsular wedge-shaped splenic infarct. She was managed conservatively with analgesia, observation, activity restriction, and interval imaging, with complete radiological and clinical resolution. This case highlights splenic infarction as a rare but likely under-recognised complication of EBV infection that can mimic more common abdominal pathology. Clinicians should maintain a high index of suspicion for splenic complications in patients with infectious mononucleosis who develop new or focal left upper quadrant abdominal pain, as prompt diagnosis facilitates appropriate management.