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Indian Pediatr 2013;50: 886 |
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Splenic Infarction in P.Vivax Malaria
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Kailash C Tamaria and Shweta Agarwal
Department of Pediatrics, Pt Madan Mohan Malviya
Hospital, New Delhi.
Email: [email protected]
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The splenic infarction is rare complication in acute
malaria; and cases have been reported in children due to
falciparum malaria [1]. We report a case of splenic
infarction in P. vivax malaria.
A 6-year-old presented with fever for 5
days and pain in left hypochondrium. The child had marked
pallor, tender splenomegaly 3 cm below costal margin, and
anemia (hemoglobin 5.4 g/dL). Peripheral smear showed
trophozoites and gametocytes of P.vivax.
Ultrasonography of abdomen showed spleen 11.4 cm with
4×2.7cm wedge shaped hypoechoic area suggestive of splenic
infarct. On Color Doppler study, splenic vessels were patent
at hilum and no vascularity was observed within lesion area.
Child was treated with chloroquine, primaquine and
paracetamol. Ultrasonography after 4 weeks showed complete
resolution of the infarcted area.
Spleen infarct may be a life threatening
complication due to splenic rupture or may be complicated by
splenic abscess needing surgical intervention [2]. There are
no known predictive signs. Clinicians must be aware that
pain in the left hypochandrium occurring in acute malaria
may be due to splenic infarction [3].
References
1. Agarwal VK, Agarwal S, Pathak T.
Splenic infarction in falciparum malaria. Indian Pediatr.
1997;34:1050-1.
2. Nores M, Philleps EH, Morgenstren L.
The clinical spectrum of splenic infarction. Ann Surg.
1998;64:182-8.
3. Bonnard P, Guiard-Schmid JB, Develoux M, Rozenbaum W,
Pialoux G. Splenic infarction during acute malaria. Trans R
Soc Trop Med Hyg. 2005; 99:82-6.
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