Nonoperative Management of Infectious Mononucleosis-Associated Splenic Rupture: A Case Report.

INTRODUCTION

Atraumatic splenic rupture is an extremely rare but serious complication of infectious mononucleosis.

CASE PRESENTATION: We present the case of an 18-year-old female who presented with atraumatic splenic rupture in the setting of infectious mononucleosis. Her past medical history was significant for postural orthostatic tachycardia syndrome, and she has a sister who was diagnosed with Ehlers-Danlos syndrome. Given her presentation and unique background, she was followed closely by surgery and hematology. The decision was made to pursue conservative management, and she was discharged home 4 days after admission with a 6-week physical activity restriction.

DISCUSSION/

CONCLUSIONS

This patient's medical and family history warranted unique clinical considerations and multidisciplinary collaboration throughout in-patient management and follow-up. The lessons learned from nonoperative management of pediatric splenic injuries may be applied successfully to medical organ rupture, working in close partnership with hematologists to understand the time course and endpoints for the underlying inflammatory condition.