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

J Med Virol. 2017 Feb;89(2):332-336. doi: 10.1002/jmv.24618. Epub 2016 Jul 6.

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.

Keywords: Epstein-Barr virus; infectious mononucleosis; splenic infarction.

Publication types

  • Case Reports
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Infectious Mononucleosis / complications*
  • Infectious Mononucleosis / diagnosis*
  • Male
  • Middle Aged
  • Splenic Infarction / etiology*
  • Splenic Infarction / pathology*
  • Young Adult