A Case of Sialolithiasis Diagnosed Using Point of Care Ultrasound

A case of infectious mononucleosis diagnosed after abdominal ultrasound is described. A 27-year-old male presented to the emergency department with fevers and sore throat for a week. He had tonsillar exudates present and his blood work showed elevated liver enzymes. Treating physician contact the ultrasound team to perform a focused right upper quadrant ultrasound to evaluate for potential biliary etiology for his lab abnormalities. On ultrasound gallbladder and common bile duct appeared normal. Given his symptoms the team then scanned his spleen which revealed splenomegaly with spleen size 16.6 cm. This prompted a recommendation from the ultrasound team for the treating physician to test the patient for infectious mononucleosis and his subsequent rapid test was positive. Use of bedside ultrasound for evaluation of the spleen in nontraumatic settings is an underutilized tool, and can help guide clinical decision making in the appropriate settings.