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

Subcapsular Splenic Hemorrhage in Vivax Malaria

  • 1Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon 22332, Korea. jhbaek@inha.ac.kr
  • 2Department of Internal Medicine, Seogwipo Medical Center, Jeju 63585, Korea.
  • 3Department of Emergency Medicine, Inha University School of Medicine, Incheon 22332, Korea.
  • 4Department of Tropical Medicine, Inha University School of Medicine, Incheon 22332, Korea.


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.


Plasmodium vivax; hemorrhage; malaria; spleen; splenic rupture

MeSH Terms

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