Splenic infarction in babesiosis: A rare presentation

Gupta, Ashish; Patel, Poras; Manvar, Kapil; Kellner, Timothy; Guevara, Elizabeth

doi:10.1002/ccr3.2301

Cited by 5 publications

(2 citation statements)

References 39 publications

(95 reference statements)

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“…While advances in diagnostic techniques have become widely available, a high clinical suspicion must be maintained for those in endemic areas, particularly when atraumatic splenic rupture does not have an identifiable cause. Some studies identify a mortality rate of 5% in patients with babesiosis, which may be higher in those who are elderly, immunocompromised, or have high parasitemia [ 2 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Babesiosis Presenting as Splenic Rupture in the Midwest: A Case Report

Mateja,

Yglesias,

Tapias

et al. 2024

Cureus

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Babesia microti is a parasite that invades erythrocytes inducing hemolysis. It presents with a variety of non-specific symptoms that can be mistaken for other illnesses. A rare manifestation of babesiosis is splenic rupture, generally seen in a younger, healthier population with low parasitemia, which can be treated conservatively depending on the grade and clinical condition. This case describes an elderly male with multiple comorbidities who is an avid hiker in the Northern Ohio and Western Pennsylvania areas presenting with a spontaneous American Association for the Surgery of Trauma (AAST) grade V splenic rupture requiring emergent splenectomy. Subsequent re-admission was required to diagnose babesiosis, which was managed with pharmacotherapy and plasmapheresis. In lieu of other identifiable etiologies, patients with atraumatic splenic rupture in an endemic area should be screened for possible parasitic infections.

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Section: Discussionmentioning

confidence: 99%

Babesiosis Presenting as Splenic Rupture in the Midwest: A Case Report

Mateja,

Yglesias,

Tapias

et al. 2024

Cureus

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“…Infection Cytomegalovirus [6][7][8] Epstein-Barr virus [9][10][11][12][13][14][15] Infective endocarditis [16][17][18][19][20][21][22] COVID-19 [23][24][25][26][27][28][29][30][31][32][33][34][35] Dengue virus [36] Mycoplasma pneumoniae [37,38] Malaria [39,40] Scrub typhus [41,42] Aspergillus pericarditis [43] Babesiosis [44] Malignancy including neoplasm and myeloproliferative diseases…”

Section: Causes Of Splenic Infarction Referencesmentioning

confidence: 99%

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

et al. 2023

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Background Splenic infarction is a frequently missed diagnosis in acute clinical conditions and is often under-diagnosed due to the lack of high-quality evidence on pathophysiology of splenic infarction. Due to the scarcity of such evidence, no consensus guidelines regarding the diagnostic approach and management of patients with splenic infarction exist. Most of published articles on splenic infarction are case reports and there was no systematic review on splenic infarction. Methods We conducted a retrospective analysis of all radiologically confirmed cases of splenic infarction patients with any history of admission at National Center for Global Health and Medicine Kohnodai Hospital, from 2014 to 2020. Further, to understand the pathophysiology that causes splenic infarction, we searched the literatures on splenic infarction. Results We found 18 patients with splenic infarction. The average age was 78 years, and about half of patients had abdominal pain; however, the other half did not have abdominal pain. One-third of patients with splenic infarction died. Leukocytosis with neutrophilia, a decrease of lymphocytes, anemia, hypoalbuminemia, and liver dysfunction were observed. Fibrinogen was decreased and D-dimer was remarkably elevated. Lactate dehydrogenase (LDH) and C-reactive protein (CRP) were remarkably increased. Six patients (33.3%) had cancer, four patients (22.2%) had atrial fibrillation, and four patients (22.2%) had infection. We found 466 case reports on splenic infarction published from 1975 to 2021. Recently, the number of case reports on splenic infarction due to infection, especially, coronavirus disease 2019 (COVID-19), has been remarkably increasing. Furthermore, we found that leukocytosis, a decrease of lymphocytes, elongated activated partial thromboplastin time, decrease of fibrinogen, liver dysfunction, elevation of LDH and blood urea nitrogen can be the prognosis predicting factors for patients with splenic infarction. Conclusion Our study elucidated clinical, hematological, biochemical and radiological characteristics for patients with splenic infarction. We newly found significant differences in blood cell counts, coagulation markers, transaminases, LDH and blood urea nitrogen between patients who died and those who survived, suggesting that these parameters can be the prognosis predicting factors for splenic infarction. Further, our systematic review on case reports about splenic infarction showed the etiology of splenic infarction and the trend of the causative diseases.

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