Hemorrhage into a Preformed Splenic Cyst as a Rare Complication of Epstein-Barr Virus Infection

Introduction

Spontaneous rupture of the spleen and splenic hemorrhage are a very rare complication of infectious mononucleosis (IM) (Jeffrey I. Cohen. Harrison’s Innere Medizin. 15. Aufl. Deutsche Ausgabe. Berlin. ABW Wissenschaftsverlag
2003; 184: 1221). Although this viral infection usually follows a benign and self-limited clinical course and resolves within four weeks, about 5 % of patients experience complications including a chronic clinical course, involvement of other organs, and rupture of the spleen. The incidence of spontaneous splenic rupture stands at 0.1 – 0.5 % of all patients with confirmed IM (Steiner-Linder A et al. Schweiz Med Wochenschr 2000; 130: 1695 – 1698). The management of spontaneous splenic rupture, whether spontaneous or secondary to trauma, has gone through a general transition. Although splenectomy was once considered the treatment of choice due to the increased risk of hemorrhage, there is currently increased justification under certain circumstances for a conservative approach in hemodynamically stable patients.