Ruptured Spleen in Infectious Mononucleosis

S. Barry Sakulsky, MD; Robert B. Wallace, MD; Murray N. Silverstein, MD; Malcolm B. Dockerty, MD
Arch Surg. 1967;94(3):349-352. doi:10.1001/archsurg.1967.01330090043010.
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ALTHOUGH spontaneous rupture of the spleen in infectious mononucleosis is a relatively rare complication, it is the most common cause of death in these patients. In reviewing 44 cases of spontaneous rupture of the spleen, Smith and Custer1 found that infectious mononucleosis was second only to malaria as the cause of rupture.

The first well-documented case of infectious mononucleosis complicated by splenic rupture was reported by King2 in 1941. In 1962, York3 reviewed 45 previously reported cases and added a case from his own experience. Since then, there have been a number of reports,4-8 and recently a case of ruptured spleen secondary to infectious mononucleosis was encountered at the Mayo Clinic. This was the first in spite of the large number of cases of infectious mononucleosis that have been seen at this institution.

Report of Case  A 17-year-old white girl was admitted to the hospital on


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