EBV : not your Everyday Benign Virus.

BACKGROUND: Epstein-Barr virus infection is common, with seroprevalence of 90% in adults. Clinical presentation of primary EBV infection can be variable and atypical. It is often subclinical or can result in infectious mononucleosis. Clinical course is mostly benign, but in rare cases serious short- and long-term complications may occur. CASE PRESENTATION: We present a case of a 19-year-old woman who was admitted to the hospital with general malaise, fever, dyspnea, icterus, vomiting and diarrhea, with acute left upper quadrant pain. She was diagnosed with acute EBV-infection with hepatitis, splenomegaly and spontaneous splenic rupture. CONCLUSIONS: Spontaneous splenic rupture is an uncommon, but potentially fatal complication of infectious mononucleosis. In a patient with suspicion of EBV infection and abdominal pain, we should always be aware of the possibility of spontaneous splenic rupture and emphasis should be put on appropriate counseling.