Spontaneous Rupture of Spleen in a Malaria Patient- A Case Report

Abstract

Spontaneous splenic rupture is a life threatening complication of malaria. Splenectomy has been recommended as the treatment option for hemodynamically unstable patients. Herein, we report a 29-year-old gentleman presented with high grade fever, acute abdomen and vomiting for three days. Laboratory evaluation did not show malaria parasite on the peripheral film. A CT abdomen done outside showed splenomegaly and hemoperitoneum. The patient deteriorated and underwent emergent exploratory laparotomy. Splenectomy was performed and large clots were evacuated. The subsequent biopsy of the ruptured spleen showed marked hemorrhagic necrosis and hemozoin pigment deposits consistent with malaria sequestered spleen. Detection of such a complication requires a high index of clinical suspicion and is extremely challenging in a patient with MP negative on peripheral film.