Abstract
Infectious mononucleosis, caused by Epstein-Barr virus (EBV), is typically self-limiting but can lead to rare, life-threatening complications such as atraumatic splenic rupture (ASR). We report the case of a 16-year-old female presenting with left upper quadrant pain and peritoneal signs. The initial laboratory findings revealed grade I anemia and leukocytosis. Images obtained by simple CT revealed the presence of free intra-abdominal fluid and a perisplenic hematoma. This raised the diagnostic suspicion of splenic rupture in the context of an acute EBV infection. Emergency splenectomy was required due to hemodynamic instability. The patient recovered well postoperatively. ASR, though uncommon, demands prompt recognition and management in mononucleosis patients with abdominal symptoms and potential circulatory compromise.