{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:15:56Z","timestamp":1789798556904,"version":"4.0.1"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Splenic rupture is a rare but life-threatening complication of infectious mononucleosis, typically associated with Epstein\u2013Barr virus. Early diagnosis of infectious mononucleosis is essential for appropriate management but may be delayed by false-negative early testing and atypical presentations. We report an atypical case of infectious mononucleosis in a 17-year-old male who presented with an acute abdomen secondary to atraumatic splenic rupture confirmed on CT. Initial mononucleosis testing was negative, delaying diagnosis, but repeat testing and subsequent laboratory findings strongly supported the diagnosis of infectious mononucleosis. Despite initial conservative management, worsening symptoms and progression of the splenic hematoma necessitated partial splenectomy. This case highlights the importance of maintaining a high index of suspicion for infectious mononucleosis in young patients with atraumatic splenic rupture despite negative initial testing, as early diagnosis may help guide appropriate management.<\/jats:p>","DOI":"10.1177\/2050313x261476140","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:14:13Z","timestamp":1789622053000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["It must be mono: An atypical case of splenic rupture"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3699-4548","authenticated-orcid":false,"given":"Ujunwa","family":"Eze","sequence":"first","affiliation":[{"name":"Department of Family Medicine, WellSpan Health, York, PA, USA"},{"name":"Department of Family Medicine, WellSpan Health, Lebanon, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1555-3206","authenticated-orcid":false,"given":"Amith","family":"Jagannath","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4383-3411","authenticated-orcid":false,"given":"Rahul","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, PA, USA"},{"name":"Department of Research, WellSpan Health, York, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2197-7311","authenticated-orcid":false,"given":"Sukhjeet","family":"Kamboj","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, WellSpan Health, Lebanon, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Luzuriaga K Sullivan JL. 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Splenic rupture in infectious mononucleosis: a systematic review of published case reports. Injury 2016; 47(3): 531\u2013538. https:\/\/doi.org\/10.1016\/j.injury.2015.10.071","DOI":"10.1016\/j.injury.2015.10.071"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Chapman ALN Watkin R Ellis CJ. Abdominal pain in acute infectious mononucleosis. BMJ 2002; 324(7338): 660\u2013661. https:\/\/doi.org\/10.1136\/bmj.324.7338.660","DOI":"10.1136\/bmj.324.7338.660"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"Leung AKC Lam JM Barankin B. Infectious mononucleosis: an updated review. Curr Pediatr Rev 2024; 20(3): 305\u2013322. https:\/\/doi.org\/10.2174\/1573396320666230801091558","DOI":"10.2174\/1573396320666230801091558"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Gagnier JJ Kienle G Altman DG et al. The CARE guidelines: consensus-based clinical case reporting guideline development. 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