Introduction.

Splenic rupture associated with thrombocytopenic purpura caused by infectious mononucleosis is extremely rare. The evolution of patients with infectious mononucleosis associated with Epstein-Barr virus is favorable, self-limiting and does not require specific therapeutic interventions. The symptoms are well tolerated and have a low frequency of complications.

Case presentation.

Female 12-year-old patient presenting with diffuse abdominal pain, distension, nausea, tegument pallor and un-quantified fever for two days. Upon admission to the emergency department, hemodynamic decompensation, purpuric lesions and ecchymosis in the limbs were observed. Laboratory and cabinet studies were carried out to confirm anemia, thrombocytopenia and splenic hematoma. Finally, an exploratory laparotomy was performed considering the possibility of hemoperitoneum.

Results.

The patient presented with splenomegaly, broken subcapsular hematoma, bleeding of 4000mL and accessory spleen lobe with splenic rupture.

Conclusions.

Spontaneous splenic rupture is a rare but possible complication of infectious diseases. However, its association with thrombocytopenic purpura is extremely rare.

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