Department of Internal Medicine, Tianjin United Family Hospital, Tianjin, China.
Medicine (Baltimore). 2024 Aug 2;103(31):e39170. doi: 10.1097/MD.0000000000039170.
Splenic infarction usually occurs in patients with underlying illnesses such as thromboembolic disorders and infiltrative hematologic diseases. Herein, we report a rare case of splenic infarction in a previously healthy boy diagnosed with infectious mononucleosis (IM). Splenic infarction is a rare complication of IM and its incidence is unknown. This case report summarizes the clinical characteristics, treatment options, and anticipated time for recovery from splenic infarction in IM.
A16-year-old boy presented to our clinic with complaints of fever, sore throat, and general sweakness for 7 days. The patient was diagnosed with IM due to an Epstein-Barr virus infection. Two days later, the patient developed severe abdominal pain in the left upper quadrant and returned to our ER for further evaluation.
IM complicated with splenic infarction.
Contrast-enhanced CT confirmed the diagnosis of splenic infarction. This patient was admitted for supportive treatment and close medical monitoring. Surgical.
The patient recovered well with conservative treatment.
IM is most often seen in adolescents and young adults. Splenic infarction is a rare complication of IM, particularly in patients who do not usually have any underlying predisposing medical conditions. Contrast-enhanced CT is the imaging modality of choice in suspected cases. Early recognition and treatment of splenic infarction in patients with IM can help prevent potentially life-threatening events. Patients should be advised to avoid sports that may precipitate splenic rupture. However it is still unknown when it is safe for patients to resume sports. In our case, 6 weeks after the splenic infarction, the patient generally felt well with complete resolution of objective symptoms and splenomegaly, and resumed sports without experiencing any adverse events.
脾梗死通常发生于存在血栓栓塞性疾病和浸润性血液病等基础疾病的患者中。在此，我们报告一例先前健康的男孩罹患传染性单核细胞增多症（IM）后发生脾梗死的罕见病例。脾梗死是 IM 的罕见并发症，其发病率尚不清楚。本病例报告总结了 IM 患者脾梗死的临床特征、治疗选择以及从脾梗死中恢复的预期时间。
一名 16 岁男孩因发热、咽痛和全身乏力 7 天就诊于我院门诊。患者因 EBV 感染被诊断为 IM。两天后，患者出现左上腹剧烈腹痛，返回我院急诊进一步评估。
IM 合并脾梗死。
增强 CT 证实了脾梗死的诊断。该患者接受了支持治疗和密切的医学监测。未进行手术。
患者经保守治疗后恢复良好。
IM 最常发生于青少年和年轻成年人。脾梗死是 IM 的罕见并发症，尤其是在通常无任何基础疾病的患者中。增强 CT 是疑似病例的首选影像学检查方法。早期识别和治疗 IM 患者的脾梗死有助于预防潜在的危及生命的事件。应告知患者避免可能导致脾破裂的运动。但是，患者恢复运动的安全性仍不清楚。在我们的病例中，脾梗死 6 周后，患者一般状况良好，客观症状和脾肿大完全缓解，恢复运动且无任何不良事件发生。
