Splenomegaly is a cardinal feature of infective endocarditis. Septic emboli and infarction were frequent findings in the preantibiotic era. However, only rare case reports of splenic rupture complicating infective endocarditis have been published. We describe a 14-year-old girl with rheumatic heart disease who had a spontaneous rupture of her spleen during the convalescent stage of infective endocarditis.
Report of a Case.—A 14-year-old girl was under periodic review for six years because of chronic rheumatic heart disease. She was admitted to our department because of weight loss and intermittent fever of three months' duration. On examination, the patient appeared acutely ill, and she had a spiking fever, with temperatures that ranged between 38 and 40 °C. Clinical evidence of mild left and right ventricular hypertrophy was noted, and auscultation of the heart disclosed moderate mitral and aortic insufficiency. A hard, tender spleen was palpated 5 cm below the left costal