Paediatric Wandering Spleens in Malawi

A Physician’s Nightmare: Fever of Unknown Origin

“…As in our patient, the history, physical exam, and diagnostic investigation showing splenomegaly are a potential diagnostic clue towards spleen related etiology for FUO. Splenomegaly can be caused by leukemia, lymphoma, infections, and wandering spleen [ 4 ].…”

“…Wandering spleen has rarely been associated with FUO. The incidence of wandering spleen is around 5% known from series of splenectomies and less than 100 reported cases in pediatrics [ 4 ]. Wandering spleen is a rare condition due to lack of ligamentous attachment of a spleen to diaphragm, colon, and retroperitoneum.…”

“…The spleen is a lymphoid organ located in left upper quadrant suspended by gastrosplenic and splenorenal ligaments [ 4 ]. Wandering spleen is a rare disorder that results from spleen being attached to pedicle instead of ligaments due to absence, abnormality, or laxity of the ligaments.…”

“…The pedicle contains blood vessels and is longer than normal. If it is not fixed it can twist on itself easily [ 4 , 5 ]. Wandering spleen is present in pediatric population with male to female ratio of 6 to 1.2 and females of childbearing age (hormones causing laxity of ligaments) [ 4 ].…”

“…If it is not fixed it can twist on itself easily [ 4 , 5 ]. Wandering spleen is present in pediatric population with male to female ratio of 6 to 1.2 and females of childbearing age (hormones causing laxity of ligaments) [ 4 ]. The common causes of fever in relation to spleen are hemolytic anemia (sickle cell anemia, spherocytosis, and thrombotic thrombocytopenic purpura), infection (parvovirus, tuberculosis, infective endocarditis, cytomegalovirus, Epstein-Barr virus, brucellosis, rocky mountain spotted fever, typhoid fever, histoplasmosis, and malaria), sarcoidosis, leukemia, and lymphoma [ 1 , 6 , 7 ].…”