Professional paper

https://doi.org/10.57140/mj.54.3.8

Splenic infarction in patients with Epstein-Barr virus infectious mononucleosis-case reports and literature review

Tomislava Skuhala orcid.org/0000-0003-0129-1519 ; Klinika za infektivne bolesti "Dr.Fran Mihaljević", Zagreb, Hrvatska; Stomatološki fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Anja Dragobratović ; Klinika za infektivne bolesti "Dr.Fran Mihaljević", Zagreb, Hrvatska
Klaudija Višković orcid.org/0000-0002-5927-3201 ; Klinika za infektivne bolesti "Dr.Fran Mihaljević", Zagreb, Hrvatska
Marin Rimac orcid.org/0000-0003-1617-4921 ; Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Alemka Markotić ; Klinika za infektivne bolesti "Dr.Fran Mihaljević", Zagreb, Hrvatska; Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska; Medicinski fakultet i Odjel za sestrinstvo Hrvatskog katoličkog sveučilišta, Zagreb, Hrvatska
Boško Desnica ; Klinika za infektivne bolesti "Dr.Fran Mihaljević", Zagreb, Hrvatska
Snježana Židovec Lepej ; Klinika za infektivne bolesti "Dr.Fran Mihaljević", Zagreb, Hrvatska

Abstract

Introduction: Epstein-Barr virus (EBV) is one of the most common herpes viruses in humans with over
90% of adults demonstrating antibodies to EBV. Infectious mononucleosis (IM) is the most frequently
occurring clinical presentation of EBV infection and typically presents with fever, tonsillitis/pharyngitis,
cervical lymph node enlargement and tenderness and fatigue. Splenomegaly is also part of the clinical
presentation. Splenic infarction (SI) due to IM is rare but its exact frequency is unknown.
Methods: We present two cases of SI accompanying IM caused by EBV in young adults without
underlying comorbidities together with a literature review of this topic. Literature search included journal
articles describing splenic infarctions confirmed by CT or MRI associated with IM due to EBV infection
published in English between 2005 and 2024 in PubMed. A total of 32 case reports presenting 34 patients
were selected for detailed analysis.
Results: Among 34 patients, 58,8% were males and the median age was 20.97 years. Only 26.5% of
patients had some chronic disease, the most common one being hereditary spherocytosis present in four
patients. The most common symptoms were: fever (82.4%), abdominal pain (88.2%) localized mostly in
the left upper abdomen and splenomegaly (50%).
Conclusion: Our overall conclusion is that establishing the diagnosis of SI does not change the
therapeutic approach in most cases and that symptomatic treatment is sufficient.
In the future, greater availability of abdominal imagining methods and a higher index of suspicion will
lead to more accurate data about SI.

Keywords

splenic infarction; Epstein-Barr virus; infectious mononucleosis; case reports; literature review

Hrčak ID:

320619

URI

https://hrcak.srce.hr/320619

Publication date:

6.9.2024.

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