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Volume 353:1421-1422 September 29, 2005 Number 13
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Medical Mystery: Abdominal Pain — The Answer

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by Kim, K. M.
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To the Editor: The Medical Mystery in the August 4 issue1 involved a 40-year-old man who presented with a four-day history of pain in the left upper quadrant of the abdomen, accompanied by fatigue, fever, sweating, and sore throat. A computed tomographic scan was obtained; it revealed multiple splenic infarcts (Figure 1) due to acute infectious mononucleosis. Laboratory studies on admission showed an elevated white-cell count (13,800 per cubic millimeter) with 51 percent lymphocytes, 31 percent of which were atypical, as well as the following abnormal liver-function values: aspartate aminotransferase, 123 U per liter; alanine aminotransferase, 244 U . . . [Full Text of this Article]



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