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Infectious Mononucleosis - Splenic Rupture: Moderate splenomegaly is a common finding in infectious mononucleosis. The cut surface of spleen is deep red due to diffusely congested red pulp. The white pulp is not prominent and is represented by occasional white specks.

Hemorrhage or spontaneous rupture of spleen is a rare but known complication in infectious mononucleosis. It occurs between 10 to 21 days after the disease onset. The resultant hemoperitoneum is a medical emergency and the most frequent cause of death in infectious mononucleosis. Other conditions associated with spontaneous splenic rupture include malaria, typhoid, infective endocarditis, peliosis lienis, malignant lymphomas, leukemias, and primary splenic malignancies (non-lymphoid).

When spontaneous splenic rupture occurs in the absence of blunt trauma to the abdomen or abdominal surgery, the spleen should be examined carefully to rule out the conditions mentioned above.

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