Korean J Parasitol.  2019 Aug;57(4):405-409. 10.3347/kjp.2019.57.4.405.

Subcapsular Splenic Hemorrhage in Vivax Malaria

• Im JH
• Chung MH
• Durey A
• Lee JS
• Kim TS
• Kwon HY
• Baek JH

• KMID: 2459478
• DOI: http://doi.org/10.3347/kjp.2019.57.4.405

Abstract

In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.

Keyword

Plasmodium vivax; hemorrhage; malaria; spleen; splenic rupture

MeSH Terms

Fatal Outcome
Follow-Up Studies
Hemorrhage*
Hypotension
Malaria
Malaria, Vivax*
Plasmodium vivax
Rupture
Spleen
Splenic Artery
Splenic Rupture
Vital Signs