Non-traumatic splenic rupture in a patient with human granulocytic anaplasmosis and focused review of the literature.

We report a rare case of a 53-year-old man with no significant past medical history who reported multiple tick bites within a 2-month period. The patient reported not "feeling well" for the 2 ½ weeks. He complained of generalized body aches, pains, and chills. He did not report nausea, vomiting, or yellowish discoloration of the eyes or skin. He presented to the emergency room with syncope preceded by severe abdominal pain. Upon presentation, he was pale and hypotensive. He had not experienced any trauma. Computed tomography revealed a splenic rupture, hemoperitoneum, and active extravasation of contrast material. The estimated amount of hemoperitoneum was 1.5 liters of blood. Subsequently, an infectious disease work-up revealed a positive Anaplasma phagocytophilum polymerase reaction in blood. The patient was aggressively resuscitated, and a splenectomy was performed followed by doxycycline therapy. He successfully recovered.