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Mild Splenomegaly (less than 3 fingers)

CLINICAL DIAGNOSTIC MANUAL



Mild splenomegaly refers to a slight enlargement of the spleen, typically palpable up to less than three fingers below the left costal margin. While the spleen can enlarge for various reasons, mild splenomegaly indicates a condition that has not yet progressed to severe enlargement.


This condition may be associated with infections, haematological diseases, and systemic disorders. Identifying the underlying cause is essential for appropriate patient management.


Condition

Symptoms and Clinical Signs

Suspected Diagnosis

Confirmatory Diagnosis

Infectious mononucleosis

Severe fatigue, fever, pharyngitis, lymphadenopathy, splenomegaly, hepatomegaly.

Clinical history, clinical symptoms

Serology for EBV, full blood count

Brucellosis

Undulant fever, night sweats, fatigue, joint and muscle pain, splenomegaly, hepatosplenomegaly.

Clinical history, exposure to animals or animal products

Serology for Brucella, blood cultures

Hepatitis

Jaundice, fatigue, general malaise, nausea, vomiting, right upper quadrant pain, hepatomegaly, splenomegaly.

Clinical history, clinical symptoms

Liver function tests, serology for hepatitis

Bacterial endocarditis

Persistent fever, new or changed heart murmur, petechiae, Janeway lesions, Osler’s nodes, splenomegaly.

Clinical history, physical examination, clinical symptoms

Blood cultures, echocardiogram

Amyloidosis

Fatigue, weight loss, hepatomegaly, splenomegaly, peripheral neuropathy, oedema.

Clinical history, clinical symptoms

Biopsy of affected tissue, serum protein electrophoresis

Haemolytic anaemia

Fatigue, pallor, jaundice, dark urine, splenomegaly, haemolytic crises.

Clinical history, clinical symptoms

Full blood count, Coombs test


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