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