title: The unexpected finding of a splenic infarction in a patient with infectious mononucleosis due to Epstein-Barr virus.
abstract: The authors present a case of a 24-year-old man with infectious mononucleosis (IM) due to Epstein-Barr virus (EBV). Among his symptoms, he reported abdominal pain in the upper left quadrant. An abdominal ultrasound and CT revealed an extensive splenic infarction. During the acute stage of this disease, the thrombophilic screening revealed reduced free protein S and elevated factor VIII, with normalisation on re-evaluation 6 weeks later. Splenic infarction is a very rare complication of IM due to EBV but should be considered in patients presenting abdominal pain. A hypercoagulability state should be investigated. To our knowledge, this is the first described case of a splenic infarction in a patient with IM due to EBV associated with a transient reduction of protein S and elevation of factor VIII. Thus, this work promotes the importance of including these factors in the thrombophilic screening conducted during the investigation of similar cases.
authors.affiliation: Department of Internal Medicine, Hospital de Santo Espírito da Ilha Terceira, Angra do Heroísmo, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Machado
authors.affiliation: Unidade de Saúde da Ilha Terceira-Centro de Saúde de Angra do Heroísmo, Angra do Heroísmo, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Melo Salgado
authors.affiliation: Department of Internal Medicine, Hospital de Santo Espírito da Ilha Terceira, Angra do Heroísmo, Portugal.
authors.forename: Leonor
authors.initials: L
authors.lastname: Monjardino
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D005169:Factor VIII / Q000378:metabolism; D004854:Herpesvirus 4, Human; D006801:Humans; D007244:Infectious Mononucleosis / Q000097:blood / Q000150:complications*; D008297:Male; D017293:Protein S / Q000378:metabolism; D013159:Splenic Infarction / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult
chemical_list: D017293:Protein S; D005169:Factor VIII