Spontaneous Splenic Rupture Complicating Severe P. falciparum Infection: A Case Report and Literature Review

Abstract

Spontaneous rupture of the spleen in malarial infection or malarial splenic rupture (MSR) is a rare but life-threatening condition complicating severe malarial infection in tropics and subtropics, and hence it deserves special attention. A high index of clinical suspicion is warranted for the early diagnosis as delayed or missed diagnosis can be potentially fatal. We report on a 32-year-old male who was diagnosed with severe Plasmodium falciparum infection and presented with an acute abdomen due to spontaneous splenic rupture. He was managed conservatively and had a successful outcome. The epidemiology, pathophysiology, clinical presentation, and management of MSR were briefly discussed in this report.

Atraumatic splenic rupture – unexpected consequences of a world trip

“…This case of a well-known, yet rare complication of malaria demonstrates various aspects potentially useful for the clinical management of malaria. Insofar as this can be concluded from a relatively small number of case reports, males, travelers, and naive hosts seem to have the highest relative incidence for atraumatic splenic rupture as a complication of malaria [6]. This same group of patients faces an increased risk for a severe course of malaria disease in general due to the lack of immunity against the parasite, while people with repeated exposure to the parasite develop partial protective immunity [3].…”

Spontaneous splenic rupture: A rare complication of acute myeloid leukemia. Report of a case

“…According to the Orloff and Peskinin 1958 criteria, splenic rupture should be considered “spontaneous” only if it occurs without trauma history or other spleen pathologies [ 1 ].Spontaneous rupture of the spleen is a very rare affection. Infectious and hematological diseases represent more than half of its causes, infections are due to: infectious mononucleosis, malaria and cytomegalovirus, while hematological causes are mainly due to malignant tumors such as leukemia, Hodgkin's and non-Hodgkin's lymphomas (NHL) [ 3 ]. Other cases of spontaneous rupture of the spleen include: congenital splenic lesions such as hamartoma and hemangioma, spleen infarction, clotting disorders, thrombocytopenia, autoimmune diseases, hemolytic anemia, pregnancy, amyloidosis, portal hypertension and focal splenic lesions [ 1 , 4 ].…”

Spontaneous rupture of the Spleen due to Malaria: A Case Report

“…historically, splenectomy was the treatment of choice in all cases of malarial splenic rupture. But recently some authors have advocated conservative treatment as an alternative, especially in hemodynamically stable to prevent the adverse effects of splenectomy [5]. Conclusion: Spontaneous splenic rupture due to malaria is an uncommon complication even in an endemic area and it requires a high index of clinical suspicion, especially in patients having malarial infection presenting with abdominal pain, and hemodynamic instability.…”

“…[4]. Malarial infection incidence in Sudan was estimated to be 9 million cases per year in 2007 with 44,000 deaths related to malaria complications [5]. The spleen plays an important role in immunity against malaria by producing antibodies against malaria parasites, this can lead to splenic enlargement making it more susceptible to complications such as hematoma formation and rupture [6].…”