Splenic infarction associated with acute infectious mononucleosis due to Epstein–Barr virus infection

Abstract

The purpose of this study was to report a case of a previously healthy 20-year-old woman diagnosed with splenic infarction following infectious mononucleosis (IM) by Epstein-Barr virus (EBV) infection and to perform the first systematic review of the clinical characteristics of splenic infarction associated with IM. A systematic review was conducted using English, French, and Japanese literatures of splenic infarction associated with IM due to EBV infection published between 1961 and 2015 in PubMed Medline. A total of 19 cases were extracted from the collected articles. Left upper quadrant (LUQ) pain was observed in 15 (79%) patients. Splenectomy was performed in five (26%) cases, among which four patients presented with stable vital signs. Splenic rupture was accompanied in two (10%) patients. The median time from the onset of IM symptoms to the diagnosis of splenic infarction was 5 days (range, 1-25 days). Fourteen (74%) of 19 patients experienced improvement through medical treatment, and there were no deaths. Splenic infarction associated with IM due to EBV infection can show a favorable clinical outcome after medical treatment. Clinicians should consider the possibility of splenic infarction when patients with IM experience LUQ pain. J. Med. Virol. 89:332-336, 2017. © 2016 Wiley Periodicals, Inc.

Splenic infarct in a patient with Infectious Mononucleosis: a rare presentation

“…Due to the enlargement of the spleen, which in some cases can be up to twice the size, the blood supplied by the arteries does not meet the demand of the organ as a result of the hypercellularity interrupting the blood flow. It is also unknown if the viral load has a role in the degree of hypercellularity or change in size of the spleen in the setting of an acute infection that may increase the chances of an infarction [9]. Other causes revolve around the presence of a transient hypercoagulable state, caused by a decrease in the levels of protein C and protein S, compounded by an increase in the size of the spleen, resulting in an infarct [10,11].…”

Cytomegalovirus-Associated Splenic Infarction in a Young Female Patient

“…Infections associated with splenic infarction can be seen in endocarditis, malaria, and viral infections such as CMV, parvovirus B19, EBV and human herpesvirus type 6, and HIV [ 5 , 7 ]. Sometimes, there may be a cross-reaction and false-positive EBV immunoglobulins in CMV infections [ 1 ].…”

Infarto esplénico masivo en un paciente pediátrico sin factores predisponentes

“…Las etiologías más frecuentes relacionadas con esplenomegalia masiva son leucemia mieloide crónica, mielofibrosis primaria, mielofibrosis secundaria a policitemia vera o trombocitosis primaria, enfermedad de Gaucher, linfoma de células pequeñas, leucemia de células peludas, kala azar (leishmaniasis visceral), talasemia mayor y el síndrome palúdico con esplenomegalia reactiva, conocida como esplenomegalia tropical. 5,9 Prácticamente, todas ocurren en la edad adulta, y muy pocas de ellas en la edad pediátrica. Casi todas se pueden descartar debido a la edad de presentación, a la evolución y a los estudios de laboratorio iniciales, así como los estudios complementarios de diagnóstico.…”