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].

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.