Su un caso autoptico di rottura splenica da mononucleosi infettiva. Valutazione del nesso di causalità materiale

The Authors describe a case of a 14-year-old, who died of a spontaneous rupture of the spleen immediately after arriving at a First Aid Department. The diagnostic examination revealed a hemoperitoneum and laceration of the spleen that, in view of the young age of the victim, led the medical staff to request a postmortem. The autopsy and subsequent serologic and histological tests allowed for the formulation of an exact diagnosis of death. In fact, apart from the considerable splenomegaly with capsular laceration and perisplenic hematoma, the autopsy showed widespread, relevant lymphadenopathy, associated with a pulmonary and tonsillar inflammation. The serologic tests were positive for the recent, but no longer active, Epstein Barr virus infection. Lastly, examination of the histological preparations confirmed the important, almost systemic inflammatory scenario. The objective of this work was to analyse the event that led to the death of the young girl, in light of the main forensic concepts of causal nexus.