Spontaneous Splenic Rupture Following Severe Cough in a Patient With Community-Acquired Pneumonia: A Case Report

We describe a rare case involving the spontaneous rupture of the spleen in a man in his mid-70s who initially came to the emergency department with progressively worsening shortness of breath, a productive cough with yellow-green sputum, and chest pain worsened by breathing. He was initially diagnosed with pneumonia. However, shortly after admission, he rapidly deteriorated, developing severe abdominal pain, a sudden drop in blood pressure, and a significant decrease in hemoglobin, indicating acute internal bleeding. An urgent computed tomography (CT) scan confirmed extensive bleeding around his spleen, consistent with spontaneous rupture, likely due to increased abdominal pressure from intense coughing. The patient underwent emergency surgery to remove his spleen and evacuate blood from the abdomen, followed by care in the intensive care unit. His recovery afterward was smooth, and he gradually improved without further complications. This case highlights the need for doctors to remain alert to spontaneous splenic rupture when patients with respiratory infections develop unexplained abdominal symptoms and internal bleeding. Early diagnosis and rapid surgical treatment proved essential in ensuring a positive outcome for this patient.