[Spontaneous splenic rupture in acute malaria tropica].

Abstract

A 44-year-old man developed bouts of fever (up to 40 degrees C) seven days after returning from a holiday in Kenya. Malaria prophylaxis with chloroquine had been correctly undertaken. Concentrations of lactate dehydrogenase and total bilirubin were raised (493 U/l and 3.55 mg/dl, respectively). Blood smear revealed the ring forms of Plasmodium falciparum. Thereupon the patient was given mefloquine in decreasing doses (750/500/250 mg) at intervals of 8 hours. The following night he had a circulatory collapse and complained of pain on pressure, especially in the left upper abdomen. Abdominal sonography showed a slightly enlarged spherical spleen with an echo-poor band and fluid collection in the rectovesicular pouch, indicating rupture of the spleen. A splenectomy was performed. Subsequently the number of malaria organisms in the blood smear gradually fell and signs of haemolysis disappeared. Splenic rupture is a very rare complication of acute malaria. It is presumably caused by marked stasis in the splenic sinuses with deformed parasite-containing red blood cells.

• Authors: S Falk, H Protz, U Köbrich, H J Stutte
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 117 Issue 22 Pg. 854-7 (May 29 1992) ISSN: 0012-0472 [Print] Germany
• Vernacular Title: Spontane Milzruptur bei akuter Malaria tropica.
• PMID: 1597109 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Acute Disease
• Adult
• Combined Modality Therapy
• Diagnosis, Differential
• Humans
• Malaria, Falciparum (complications, diagnosis, therapy)
• Male
• Rupture, Spontaneous
• Spleen (pathology)
• Splenic Rupture (diagnosis, etiology, therapy)