P-O12 Atraumatic Splenic Rupture Secondary to Concurrent Cytomegalovirus and Epstein Barr Virus Infection

Abstract Background Infectious Mononucleosis (IM) is a common viral illness among adolescents and young adults. While most cases are self-limiting, small number of patient can develop life threatening complications, such as atraumatic splenic rupture (ASR). This rare but serious sequelae, the commonest cause associated mortality. Epstein Barr Virus commonly with IM, concurrent infection cytomegalovirus (CMV) EBV rarely reported. Both infections splenomegaly, however this usually mild very results in ASR. Methods We present case an immunocompetent nineteen year old male who underwent emergency splenectomy for ASR secondary to CMV infection. He presented Emergency Department five hour history severe, sudden onset left upper quadrant pain preceded by coughing fit. reported one incidental splenomegaly recent positive monospot test community. Computerised tomography (CT) abdomen pelvis confirmed large haemo-peritoneum sub-capsular haematoma. was haemodynamically unstable laparotomy splenectomy. Results Intraoperative findings included two litres intraperitoneal blood spleen haematoma; approximately seventeen centimetre diameter weighed nine hundred seventy grams. Pathology showed features non-specific lymphoid hyperplasia. Serum virology high levels on polymerase chain reaction low detected. Virology screening incidentally repeated post discharge at time consistent acute No alternative or pre-existing has been identified. Conclusions The serology confirm likely we cannot confidently identify which virus caused case, condition important differential patients presenting LUQ shock. Splenectomy remains treatment choice patients.