Spontaneous splenic rupture: an uncommon complication of cytomegalovirus infection

Rogues, A.-M.; Dupon, M.; Cales, Valérie; Malou, M.; Paty, Morgan; Bail, Brigitte Le; Lacut, J. Y.

doi:10.1016/s0163-4453(94)95195-0

Cited by 19 publications

(8 citation statements)

References 6 publications

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“…HHV have been known for many years to cause splenomegaly, which on occasion can lead to splenic rupture (162). Spontaneous splenic rupture is less common in acute CMV infection than EBV infection, despite one-third of acute CMV infections demonstrating splenomegaly (163–165). In contrast, HHV infection after splenectomy likely represents a distinct clinicopathologic syndrome (166).…”

Section: Virusesmentioning

confidence: 99%

Resistant Pathogens, Fungi, and Viruses

Guidry

Mansfield

Sawyer

et al. 2014

Surgical Clinics of North America

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The first reports of antibiotic pathogens occurred a few short years after the introduction of these powerful new agents, heralding a new kind of war between medicine and pathogens. Although originally described in Staphylococcus aureus, resistance among bacteria has now become a grim race to determine which classes of bacteria will become more resistant, pitting the Gram positive staphylococci, enterococci, and streptococci against the increasingly resistant Gram negative pathogens, e. g., carbapenemase-resistant enterobacteriaceae. In addition, the availability of antibacterial agents has allowed the development of whole new kinds of diseases caused by non-bacterial pathogens, related largely to fungi that are inherently resistant to antibacterials. All of these organisms are becoming more prevalent and, ultimately, more clinically relevant for surgeons. It is ironic that despite their ubiquity in our communities, there is seldom a second thought given to viral infections in patients with surgical illness. The extent of most surgeon’s interest in viral infections ends with hepatitis and HIV, no doubt related to transmissibility as well as the implications that these viruses might have in a patient’s hepatic or immune functions. There are chapters and even textbooks written about these viruses so these will not be considered here. Instead, we will present the growing body of knowledge of the herpes family viruses and their occurrence and consequences in patients with concomitant surgical disease or critical illness. We have also chosen to focus this chapter on previously immune competent patients, as the impact of herpes family viruses in immunosuppressed patients such as transplant or AIDS patients has received thorough treatment elsewhere.

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Section: Virusesmentioning

confidence: 99%

Resistant Pathogens, Fungi, and Viruses

Guidry

Mansfield

Sawyer

et al. 2014

Surgical Clinics of North America

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“…In all patients, serology examinations were positive for IgM anti-CMV antibodies [4, 6–9], and in one case typical intranuclear inclusions for CMV were identified in the surgical specimen [7]. All patients were treated with splenectomy and had a full recovery [4, 6–9].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Spleen Rupture in a Teenager: An Uncommon Cause of Acute Abdomen

Verroiotou¹,

Saad²,

Fardellas³

2013

Case Reports in Medicine

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Spontaneous spleen rupture is a rare complication of infectious diseases and it can become a potentially life-threatening condition if not diagnosed in time. A 17-year-old Greek female presented to the ER due to acute abdominal pain, mainly of the left upper quadrant. She had no recent report of trauma. The patient was pale, her blood pressure was 90/70 mmHg, and her pulse was 120 b/min. Clinical examination of the abdomen revealed muscle contraction and resistance. The patient was submitted to an ultrasound of the upper abdomen and to a CT scanning of the abdomen that revealed an extended intraperitoneal hemorrhage due to spleen rupture. Due to the patient's hemodynamic instability, she was taken to the operation room and splenectomy was performed. Following a series of laboratory examinations, the patient was diagnosed to be positive for current cytomegalovirus infection. The postoperative course was uneventful, and in a two year follow-up the patient is symptom-free. Spontaneous spleen rupture due to Cytomegalovirus infection is a rare clinical entity, described in few case reports in the world literature and should always be taken into consideration in differential diagnosis of acute abdomen, especially in adolescents with no recent report of trauma.

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“…We found only eleven cases, including our own, of spontaneous splenic rupture or subcapsular hematoma during primary CMV infection (table I). Two cases of "isolated painful splenomegaly suggesting impending rupture" [1][2][3][4][5][6][7] were excluded because insufficiently documented. It is, however, likely that many cases of splenic rupture in primary CMV infection are unreported.…”

Section: Infection In Immunocompetent Patients Published Inmentioning

confidence: 99%

“…There is also a decided lack of certainty in labeling splenic rupture as "spontaneous" or ascribing it to a minor unnoticed trauma [8]. In 4 of 10 cases [2][3][4][5] the splenic lesion was actually a subcapsular hematoma; the remainder had total or partial splenic rupture. Hemoperitoneum was documented in 7 cases [1,3,6,7,9,10], including one of ours.…”

Section: Infection In Immunocompetent Patients Published Inmentioning

confidence: 99%