NDLI: Epstein-Barr Virus-Associated Atraumatic Spleen Laceration Presenting with Neck and Shoulder Pain.

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Year: 2014 Volume: 15

Year: 2013 Volume: 14

Year: 2012 Volume: 13

Epstein-Barr Virus-Associated Atraumatic Spleen Laceration Presenting with Neck and Shoulder Pain.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sergent, Shane R. Johnson, Sophia M. Ashurst, John Johnston, Greg
Description	Country affiliation: United States Author Affiliation: Sergent SR ( Department of Emergency Medicine, Conemaugh Memorial Hospital, Johnstown, PA, USA.); Johnson SM ( Department of Emergency Medicine, Conemaugh Memorial Hospital, Johnstown, PA, USA.); Ashurst J ( Department of Emergency Medicine, Conemaugh Memorial Hospital, Johnstown, PA, USA.); Johnston G ( Department of Emergency Medicine, Conemaugh Memorial Hospital, Johnstown, PA, USA.)
Abstract	BACKGROUND: Infectious mononucleosis, caused by the Epstein-Barr virus (EBV), is a common infection with worldwide distribution; more than 90% of people have been infected by adulthood. One of the most feared, albeit rare, complications, occurring in less than 0.5% of those infected, is splenic injury or rupture. CASE REPORT: A febrile 15-year-old male presented to the emergency department with the chief compliant of headache, neck pain, and upper shoulder pain. He did not recall any specific traumatic injury. His abdomen was soft, nondistended, and was tender in the right and left lower quadrants. Right lower quadrant ultrasound demonstrated non-visualization of the appendix, moderate right lower quadrant free fluid, and positive McBurney's sign. CT of the abdomen and pelvis was ordered, which demonstrated moderate splenomegaly, with findings compatible with laceration through the anterior aspect of the spleen, with moderate hemoperitoneum. Monospot was negative and EBV panel demonstrated IGG negative, IGM positive, and, IGG negative. The patient was transferred to interventional radiology for a splenic angiogram and proximal splenic artery embolization. The angiogram demonstrated grade 3 laceration with moderate hemoperitoneum and no active extravasation or evidence of pseudoaneurysm. The patient was admitted and made a prompt recovery without any other sequelae. CONCLUSIONS: The presentation of splenic injury or rupture can vary; the patient may complain of abdominal pain or left upper quadrant pain, may exhibit referred left shoulder pain when the LUQ is palpated (Kehr's Sign), or may exhibit hemodynamic instability. Given the spectrum of non-specific symptoms, diagnosing EBV-induced splenic laceration can be difficult.
File Format	HTM / HTML
e-ISSN	19415923
Journal	American Journal of Case Reports
Volume Number	16
Language	English
Publisher	International Scientific Information
Publisher Date	2015-10-30
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Medicine Epstein-barr Virus Infections Complications Herpesvirus 4, Human Neck Pain Etiology Shoulder Pain Splenic Rupture Adolescent Diagnosis, Differential Diagnosis Rupture, Spontaneous Tomography, X-ray Computed
Content Type	Text
Resource Type	Article

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