Splenic infarct in a patient with heterophile antibody negative/epstein-barr virus PCR positive infectious mononucleosis.

Infectious mononucleosis has frequently been associated with splenic pathology, most significantly splenic rupture, but splenic infarction has been reported as a rare complication. Our case describes a 24-year-old male with a mononucleosis-like illness but with a negative heterophile antibody (Monospot), who later returned with left upper quadrant pain and was diagnosed with splenic infarct on contrast computed tomography. His Epstein-Barr Virus polymerase chain reaction returned positive, and workup for an underlying hematologic cause of thromboembolism was negative. This report draws attention to the complication of splenic infarct in infectious mononucleosis, the importance of searching for causes of hypercoagulability, malignancy and patent foramen ovale, and the need for further guidance on optimal management.