Splenic infarction associated with acute cytomegalovirus infection (CMV) in immunocompetent patients was initially described as a very rare occurrence but has been reported in recent years with increasing frequency. Many cases undergo multiple investigations only to leave acute CMV as the likely cause. There is a risk of splenic rupture and, although this complication is rare, fatalities have occurred.
Although the exact mechanism of CMV as a vascular pathogen is unclear, there are now multiple reports describing venous thrombosis and arterial infarction in the presence of this acute viral infection. Our case prompted a review of the literature, and we suggest splenic infarction should be recognised as a possible complication of acute CMV.