Non hypoxia-related splenic infarct in a patient with sickle cell trait and infectious mononucleosis

Splenic infarction in patients with sickle cell trait is usually related to hypoxic conditions, while non-hypoxia-related infarcts are extremely rare, We report on a case of a 17-year-old male patient, living at sea level, wh o developed a severe left upper quadrant abdominal pain during the course o f a febrile episode, On physical examination he had a mildly palpable but e xtremely painful spleen, A spleen scan revealed 2 areas of impaired radio-n ucleide distribution, Hepatic enzymes were moderately increased and the IgM anti-EBV antibodies positive, Hemoglobin electrophoresis revealed the pres ence of 42% of hemoglobin S, A probable diagnosis of splenic infarction was established in a patient with sickle cell trait, during the course of infe ctious mononucleosis, The patient was treated symptomatically. The conditio ns of splenic congestion induced by the EBV infection and the high-grade fe ver may have contributed to splenic sequestration and subsequent infarcts, Copyright (C) 2001 S. Karger AG, Basel.