title: Splenic hematoma as a first manifestation of cytomegalovirus infection.
abstract: Splenic rupture is rare but life threatening complication of mononucleosis syndrome. It has been suggested that subcapsular splenic hematoma formation precedes rupture. The case of 44-year-old, previously healthy, male with splenic hematoma occurring after rising of heavy cargo is reported. Mononucleosis syndrome was suggested based on routine laboratory tests (elevated white blood cell count with predominance of lymphocytes and raised serum transaminases) and CMV infection was confirmed by serological test. Nonoperative management was used since the patient was hemodynamically stable with no further signs of splenic rupture. The same approach has been used in growing number of cases of patients with spontaneous splenic rupture in mononucleosis syndrome. Importance of considering splenic hematoma and/or rupture if abdominal pain occurs in the course of mononucleosis syndrome is outlined as well as importance of routine laboratory tests in suspecting mononucleosis syndrome in otherwise clinically silent patient.
authors.affiliation: Department of Infectious Diseases, University Hospital Center Rijeka, Rijeka, Croatia. nada.brncic@medri.hr
authors.forename: Nada
authors.initials: N
authors.lastname: Brncić
authors.forename: Brankica
authors.initials: B
authors.lastname: Mijandrusić-Sincić
authors.forename: Relja
authors.initials: R
authors.lastname: Perić
authors.forename: Sandra
authors.initials: S
authors.lastname: Milić
authors.forename: Lari
authors.initials: L
authors.lastname: Gorup
authors.forename: Marzena
authors.initials: M
authors.lastname: Mazur-Grbac
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000821:virology; D000328:Adult; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000821:virology*; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous; D013154:Spleen / Q000000981:diagnostic imaging / Q000821:virology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography