Spontaneous splenic rupture in infectious mononucleosis.

Spontaneous splenic rupture is a rare but life-threatening complication of infectious mononucleosis. Patients typically present with acute abdominal pain most marked in the left lower abdomen. Occasionally the pain is referred to the left shoulder and preceded by "flu-like" symptoms. Palor, orthostasis, and tachycardia can also be observed. Because abdominal pain and tachycardia are unusual in uncomplicated cases of infectious mononucleosis, the possibility of spontaneous splenic hematoma or rupture must be considered. The case presented here typifies the clinical manifestations of this entity and illustrates appropriate management.