Spontaneous Rupture of Spleen in a Patient with Malarial Infection

ABSTRACT

Malaria is a protozoan disease transmitted by the bite of infected mosquitoes. During acute and chronic malarial infection, altered splenic structure and function produce asymptomatic enlargement or com plications such as hematoma formation, rupture, hypersplenism, or cyst formation. Spontaneous splenic rupture occurs during acute infection, usually during the primary attack. However, rupture occurring in chronic malarial splenomegaly is seldom spontaneous; obvious trauma is almost always the precipitating event. Recently, conservative therapy has been applied in all cases of malarial splenic rupture. Surgical therapy should be reserved for patients with severe rupture or for those with continued or recurrent bleeding. We report the case of a recently treated 25-year-old male who had acute malaria complicated by fever and by severe abdominal pain, tenderness, and distension, a condition that may result in splenic rupture. At operation, the spleen was slightly enlarged and multiple tearing was found in the lateral surface of the capsule. A splenectomy was preformed.