Rupture spontanée de la rate au cours d'une infection à cytomégalovirus: cas clinique et revue de la littérature

Spontaneous spleen rupture in a teenager: an uncommon cause of acute abdomen

Spontaneous spleen rupture is a rare complication of infectious diseases and it can become a potentially life-threatening condition if not diagnosed in time. A 17-year-old Greek female presented to the ER due to acute abdominal pain, mainly of the left upper quadrant. She had no recent report of trauma. The patient was pale, her blood pressure was 90/70 mmHg, and her pulse was 120 b/min. Clinical examination of the abdomen revealed muscle contraction and resistance. The patient was submitted to an ultrasound of the upper abdomen and to a CT scanning of the abdomen that revealed an extended intraperitoneal hemorrhage due to spleen rupture. Due to the patient's hemodynamic instability, she was taken to the operation room and splenectomy was performed. Following a series of laboratory examinations, the patient was diagnosed to be positive for current cytomegalovirus infection. The postoperative course was uneventful, and in a two year follow-up the patient is symptom-free. Spontaneous spleen rupture due to Cytomegalovirus infection is a rare clinical entity, described in few case reports in the world literature and should always be taken into consideration in differential diagnosis of acute abdomen, especially in adolescents with no recent report of trauma.

Successful Nonoperative Management of Spontaneous Splenic Hematoma and Hemoperitoneum due to CMV Infection

Introduction. Spontaneous splenic hematoma or splenic rupture due to CMV infection in immunocompetent adults is rare and life-threatening. Case Report. Herein we report a rare case of spontaneous splenic hematoma and hemoperitoneum due to CMV infection in a 23-year-old Caucasian male in whom conservative management was successful. Conclusion. Spontaneous splenic hematoma and spontaneous splenic rupture are extremely rare conditions during primary CMV infection. Though rare, they must be always considered by the operating surgeon, because any misinterpretation may result in unfavorable outcomes.

Non-surgical management of spontaneous splenic rupture due to Babesia microti infection

Babesiosis is an emerging tick-borne infection. We describe 2 hospitalized patients from the United States with spontaneous splenic rupture attributable to Babesia microti infection. The first patient was a 36-year-old previously healthy man with a low-grade splenic rupture not requiring surgical intervention. The second was a 70-year-old healthy man whose splenic rupture required proximal splenic artery embolization. Since the spleen is an important organ involved in controlling Babesia infection, management of splenic rupture in an infected patient using an organ preserving approach when appropriate may be preferred.