Spontaneous splenic rupture in Plasmodium knowlesi malaria

Chee, Yik Chang and Wei, Chiang Pui and Khamisah, Binti Abdul Kadir and Balbir, Singh (2018) Spontaneous splenic rupture in Plasmodium knowlesi malaria. Malaria Journal, 17. pp. 1-4. ISSN 1475-2875

PDF Spontaneous splenic rupture in Plasmodium knowlesi malaria.pdf Download (1MB)

Abstract

Background: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria. Case presentation: A 46-year-old man presented with fever and acute surgical abdomen with concomitant P. knowlesi malaria infection at Kapit Hospital. He was in compensated shock upon arrival to the hospital. He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fuid in the abdomen. He underwent emergency exploratory laparotomy in view of haemodynamic instability and worsening peritonism. Intraoperatively, haemoperitoneum and bleeding from the spleen was noted. Splenectomy was performed. Histopathological examination fndings were suggestive of splenic rupture and presence of malarial pigment. Analysis of his blood sample by nested PCR assays confrmed P. knowlesi infection. The patient completed a course of anti-malarial treatment and recovered well post-operation. Conclusions: Spontaneous splenic rupture is a rare complication of malaria. This is the frst reported case of splenic rupture in P. knowlesi malaria infection. Detection of such a complication requires high index of clinical suspicion and is extremely challenging in hospitals with limited resources.

Actions (For repository members only: login required)

View Item