title: Spontaneous splenic rupture in infectious mononucleosis: case report and review of the literature.
abstract: A 15-year-old previously healthy girl presented in full arrest after 1 week of flu-like symptoms, recent diagnosis of infectious mononucleosis, and 1 day of abdominal pain. There was no history of trauma. Focused assessment with sonography for trauma examination showed free fluid in the abdomen. The patient died despite aggressive resuscitative management and emergency laparotomy with splenectomy, which showed grade V splenic laceration. Infectious mononucleosis is a common viral illness of adolescence. Spontaneous splenic rupture is a rare but potentially fatal complication. Anticipatory guidance about the importance of seeking medical care if abdominal pain develops during infectious mononucleosis is crucial to early diagnosis and intervention in the case of rupture. We discuss the current literature surrounding the outpatient follow-up of splenomegaly associated with infectious mononucleosis, as well as current practice and treatment options when rupture occurs.
authors.affiliation: Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229-3039, USA. Andrea.Rinderknecht@cchmc.org
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Rinderknecht
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Pomerantz
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D017732:Air Ambulances; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006465:Hemoperitoneum / Q000139:chemically induced / Q000209:etiology; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications*; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000209:etiology; D013156:Splenectomy; D013161:Splenic Rupture / Q000209:etiology* / Q000601:surgery; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D014662:Vasoconstrictor Agents; D001241:Aspirin