Spontaneous Splenic Rupture Caused by Scrub Typhus

Abstract

Spontaneous rupture of the spleen is rarely described as a complication of scrub typhus infection. We report a previously healthy 74-year-old Thai female farmer who presented in Nakhon Ratchasima, Thailand, with a history of fever and malaise for 5 days, followed by abdominal pain for 1 day. An exploratory laparotomy was performed due to peritonitis. Operative findings revealed a ruptured spleen and hemoperitoneum. A splenectomy was performed afterward. Scrub typhus was confirmed by a 4-fold increase of IgM titer using an indirect immunofluorescence antibody assay and a positive result from the polymerase chain reaction targeting the 47- and 56-kDa genes in Orientia tsutsugamushi She responded well to intravenous chloramphenicol and defervesced within 24 hours without any complication.

Familial spontaneous splenic rupture in a patient with idiopathic splenomegaly—report of a case

“…Atraumatic rupture of the spleen is often attributed to infectious or neoplastic causes. Only several cases have been described in the literature, concerning infectious diseases as malaria [ 1 ], mononucleosis [ 2 ] and also in a patient with typhus spontaneous splenic rupture is described [ 3 ]. In patients with neoplasms, splenic rupture is described in patients with lymphomas [ 4 , 5 ], leukemia [ 6 ] and patients with splenic metastases of malignant melanoma [ 7 ].…”

Spontaneous splenic rupture associated with scrub typhus: a case report

“…Among the various scrub typhus-related complications, splenic involvement, such as splenic rupture or splenic infarction, has been reported as rare [ 7 ]. Two cases of splenic rupture associated with scrub typhus have been reported in MEDLINE, 1 in PubMed and 1 in KoreaMed [ 8 , 9 ]. The mechanism of scrub typhus-related splenic rupture is unknown.…”