Splenic rupture: a rare complication of infectious mononucleosis

Eugene Ng and Michelle Lee
Med J Aust 2014; 201 (8): 480. || doi: 10.5694/mja13.00116
Published online: 20 October 2014

A 28-year-old man presented to the emergency department with acute left upper quadrant tenderness and postural hypotension. He reported having had fever and cervical tenderness for 1 week before his presentation.

Blood tests showed an elevated white cell count with reactive lymphocytosis. A test for infectious mononucleosis heterophile antibody was positive, consistent with recent infection.

A contrast scan of the abdomen showed splenomegaly with subcapsular haematoma.

Splenic rupture after infectious mononucleosis is rare (incidence, 0.1%–0.5%), but can have disastrous consequences if overlooked.1,2

  • Eugene Ng
  • Michelle Lee

  • Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, QLD.


  • 1. Khoo SG, Ullah I, Manning KP, Fenton JE. Spontaneous splenic rupture in infectious mononucleosis. Ear Nose Throat J 2007; 86: 300-301.
  • 2. Pfaffli M, Wyler D. Lethal atraumatic splenic rupture due to infectious mononucleosis. Arch Kriminol 2010; 225: 195-200.


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