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Quality in Sport

Splenic rupture as a rare complication of infectious mononucleosis – case report
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Splenic rupture as a rare complication of infectious mononucleosis – case report

Authors

  • Katarzyna Błaszczyszyn Jan Mikulicz – Radecki University Hospital in Wroclaw , Borowska 213 , 50-556 Wrocław https://orcid.org/0009-0009-6529-8040
  • Maciej Orzechowski The Voivodeship Specialist Hospital in Wroclaw, Kamieńskiego 73A, 51-124 Wrocław https://orcid.org/0009-0005-0195-8805
  • Aleksander Wójtowicz St Hedwig of Silesia Hospital , Prusicka 53-55 , 55-100 Trzebnica https://orcid.org/0009-0002-3012-9879
  • Janusz Orzechowski St Hedwig of Silesia Hospital , Prusicka 53-55 , 55-100 Trzebnica

DOI:

https://doi.org/10.12775/QS.2024.23.54563

Keywords

mononucleosis, splenic rupture, EBV, infection, splenomegaly

Abstract

Infectious mononucleosis, caused by the Epstein-Barr virus, is a contagious disease primarily transmitted through bodily fluids, such as saliva. It is characterized by flu-like prodromal symptoms, followed by the tonsils enlargement, lymphadenopathy, and hepatosplenomegaly. Complications although rare, may include thrombocytopenia, anemia, encephalitis, myocarditis, or pancreatitis. One of the most dangerous is splenic rupture, which occurs in 0.1% to 0.5% of patients diagnosed with infectious mononucleosis.

We present the case of an 18-year-old patient, admitted to the general surgery department with acute abdominal pain, later diagnosed with Epstein-Barr virus-related splenic rupture unrelated to any trauma. The subsequent laboratory tests revealed leukocytosis, anemia, and abnormal liver function. Imaging revealed free fluid and an enlarged spleen, prompting laparoscopy, later converted to laparotomy due to surgical complexities. Splenectomy was performed, resulting in clinical improvement. Following effective treatment and implemented interventions, the patient was discharged after 7 days with specific postoperative instructions.

References

Ónodi-Nagy, K., Kinyó, Á., Meszes, A., Garaczi, E., Kemény, L., & Bata-Csörgő, Z. (2015). Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization. Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 11(1), 1. https://doi.org/10.1186/1710-1492-11-1

Tahir, F., Ahmed, J., & Malik, F. (2020). Post-splenectomy Sepsis: A Review of the Literature. Cureus, 12(2), e6898. https://doi.org/10.7759/cureus.6898

Dragomir, M., Petrescu, D. G. E., Manga, G. E., Călin, G. A., Vasilescu, C., & - (2016). Patients After Splenectomy: Old Risks and New Perspectives. Chirurgia (Bucharest, Romania : 1990), 111(5), 393–399. https://doi.org/10.21614/chirurgia.111.5.393

Womack J, Jimenez M. Common questions about infectious mononucleosis. Am Fam Physician. 2015 Mar 15;91(6):372-6.

Leung, A. K. C., Lam, J. M., & Barankin, B. (2024). Infectious Mononucleosis: An Updated Review. Current pediatric reviews, 20(3), 305–322. https://doi.org/10.2174/1573396320666230801091558

Toti, J. M. A., Gatti, B., Hunjan, I., Kottanattu, L., Faré, P. B., Renzi, S., Bianchetti, M. G., Milani, G. P., Lava, S. A. G., & Camozzi, P. (2023). Splenic rupture or infarction associated with Epstein-Barr virus infectious mononucleosis: a systematic literature review. Swiss medical weekly, 153, 40081. https://doi.org/10.57187/smw.2023.40081

Wu, M. Y., Kao, W. Y., Chan, C. Y., Yiang, G. T., Liao, W. T., & Chen, C. S. (2019). Spontaneous Splenic Rupture as a Rare Initial Presentation in an Acute Lymphoblastic Leukemia Patient. Diagnostics (Basel, Switzerland), 9(4), 152. https://doi.org/10.3390/diagnostics9040152

Eibl M. (1985). Immunological consequences of splenectomy. Progress in pediatric surgery, 18, 139–145. https://doi.org/10.1007/978-3-642-70276-1_18

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Published

2024-09-30

How to Cite

1.
BŁASZCZYSZYN, Katarzyna, ORZECHOWSKI, Maciej, WÓJTOWICZ, Aleksander and ORZECHOWSKI, Janusz. Splenic rupture as a rare complication of infectious mononucleosis – case report. Quality in Sport. Online. 30 September 2024. Vol. 23, p. 54563. [Accessed 16 June 2025]. DOI 10.12775/QS.2024.23.54563.
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Issue

Vol. 23 (2024)

Section

Medical Sciences

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Copyright (c) 2024 Katarzyna Błaszczyszyn, Maciej Orzechowski, Aleksander Wójtowicz, Janusz Orzechowski

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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