Atraumatic rupture of the spleen caused by Plasmodium falciparum, challenge in UN peacekeeping operations – a case report
Abstract
Introduction. Unlike traumatic rupture of the spleen, which is the most common consequence of blunt abdominal trauma and is well documented in the literature, and unlike the atraumatic rupture of the spleen, which is less common but also well described, spontaneous rupture of the spleen in a patient with malaria is a rare complication, with a potentially fatal outcome. Case report. A soldier aged 46 years, was hospitalized, with the clinical picture of abdominal colic and diarrhea, previously treated for a primary attack of acute malaria. During hospitalization, deterioration of health condition occurred, with the development of a clinical picture of an acute abdomen due to spontaneous rupture of the spleen which was successfully resolved by splenectomy. Conclusion. Splenectomy is the method of choice for patients with unstable clinical presentation due to atraumatic rupture of the spleen.
References
World Health Organization. World malaria report 2019 [Inter-net]. 2019 [accessed on 2024 March 13]. Available from: https://www.who.int/publications/i/item/9789241565721
Elvy A, Harbach L, Bhangu A. Atraumatic splenic rupture: a 6-year case series. Eur J Emerg Med 2011; 18(2): 124–6.
Jones AD, Khan M, Cheshire J, Bowley D. Postsplenectomy Prophylaxis: A Persistent Failure to Meet Standard? Open Fo-rum Infect Dis 2016; 3(4): ofw197.
Nzoumbou-Boko R, Yambiyo BM, Ngoagouni C, Vickos U, Mani-rakiza A, Nakouné E. Falciparum Malaria in Febrile Patients at Sentinel Sites for Influenza Surveillance in the Central Af-rican Republic from 2015 to 2018. Interdiscip Perspect Infect Dis 2020; 2020: 3938541.
Jiménez BC, Navarro M, Huerga H, López‐Vélez R. Spontaneous splenic rupture due to Plasmodium vivax in a traveler: case report and review. J Travel Med 2007; 14(3): 188–91.
Orloff MJ, Peskin GW. Spontaneous rupture of the normal spleen, a surgical enigma. Int Abstr Surg 1958; 106(1): 1–11.
Atkinson E. Death from idiopathic rupture of spleen. Br Med J 1874; 2: 403–4.
Renzulli P, Hostettler A, Schoepfer AM, Gloor B, Candinas D. Sys-tematic review of atraumatic splenic rupture. Br J Surg 2009; 96(10):1114–21.
Frank K, Linhart P, Kortsik C, Wohlenberg H. Sonographic de-termination of spleen size: normal dimensions in adults with a healthy spleen. Ultraschall Med 1986; 7(3): 134–7. (German)
Neva FA, Sheagren JN, Shulman NR, Canfield CJ. Malaria: host-defense mechanisms and complications. Ann Intern Med 1970; 73(2): 295–306.
Machado Siqueira A, Lopes Magalhães BM, Cardoso Melo G, Fer-rer M, Castillo P, Martin-Jaular L, et al. Spleen rupture in a case of untreated Plasmodium vivax infection. PLoS Negl Trop Dis 2012; 6(12): e1934.
Urban BC, Hien TT, Day NP, Phu NH, Roberts R, Pongponratn E, et al. Fatal Plasmodium falciparum malaria causes specific patterns of splenic architectural disorganization. Infect Immun 2005; 73(4): 1986–94.
Osman MF, Elkhidir IM, Rogers SO Jr, Williams M. Non-operative management of malarial splenic rupture: The Khar-toum experience and an international review. Int J Surg 2012; 10(9): 410–4.
Hershey FB, Lubitz JM. Spontaneous rupture of the malarial spleen: case report and analysis of 64 reported cases. Ann Surg 1948; 127(1): 40–57.
Kassam N, Michael S, Hameed K, Ali A, Surani S. Case Report: Sudden Splenic Rupture in a Plasmodium falciparum-Infected Patient. Int J Gen Med 2020; 13: 595–8.
Weinberg Y, Feldman A, Jakobson DJ, Mishal J. Spontaneous Pathologic Splenic Rupture in a Patient with Plasmodium fal-ciparum Infection, First Case Reported in Israel. Infect Dis Rep 2020; 12(3): 121–6.
Saad E, Elsamani E, Abdelrahman W. Spontaneous Splenic Rupture Complicating Severe P. falciparum Infection: A Case Report and Literature Review. Case Rep Infect Dis 2019; 2019: 2781647.