Malaria-Induced Splenic Infarction

Hwang, Jeong‐Hwan; Lee, Chang‐Seop

doi:10.4269/ajtmh.14-0190

Cited by 22 publications

(25 citation statements)

References 45 publications

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“…, Coxiella burnetii, Bartonella henselae , and Rickettsia species have been described [ 17 ]. Babesia species have been infrequently associated with atraumatic splenic rupture [ 18 , 20 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another theory favors the development of small subcapsular hematomas and/or splenic infarcts during acute parasitemia, which can subsequently lead to focal necrosis and splenic rupture. It has been proposed that splenic infarct and splenic rupture are different stages along a single continuum rather than 2 different processes [ 18 , 29 – 31 ]. Similar to malaria, infection with B. microti is associated with an increase in cytokines TNF-α, IFN-γ, and IL-10, as well as increase in endothelial activation markers and hypercoagulability due to decreased levels of antithrombin III, protein C, and protein S, [ 18 , 33 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Splenic Rupture as the First Manifestation of Babesia Microti Infection: Report of a Case and Review of Literature

et al. 2018

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Patient: Female, 79Final Diagnosis: Splenic rupture due to babesia microti infectionSymptoms: Abdominal discomfort • chest pain • fever • tachycardiaMedication: —Clinical Procedure: SplenectomySpecialty: Infectious DiseasesObjective:Rare diseaseBackground:Babesiosis is an emerging, tick-borne zoonosis caused by intraerythrocytic protozoa of the genus Babesia. Babesia microti is the main pathogen causing human disease and is endemic in the northeastern and upper midwestern parts of the USA. Severity of infection ranges from mild, self-limited, febrile viral-like illness accompanied by nonspecific symptoms to life-threatening infection complicated by severe hemolytic anemia, disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and renal or/and hepatic failure. Splenic rupture (SR) is a very rare but life-threatening complication of severe B. microti infection.Case Report:A 79-year-old female farmer from Wisconsin, USA was admitted during summer with hemorrhagic shock secondary to spontaneous splenic rupture. She was transfused with 3 units of packed red blood cells (PRBC) and underwent emergent splenectomy. Postoperatively, she recovered well and was discharged on postoperative day 4. However, she was re-admitted on postoperative day 10 for febrile hemolytic anemia. Further exposure history was obtained and was significant for multiple tick bites 8 weeks preceding the index hospitalization. She was promptly diagnosed with babesiosis and Lyme disease co-infection. She responded favorably to 10 days of azithromycin and atovaquone and 21 days of oral doxycycline.Conclusions:Despite its rare occurrence, SR due to B. microti infection is a dreaded complication that can rapidly progress to hemorrhagic shock and death. In contrast to other complications of babesiosis, SR is not correlated with parasite burden or immune status of the affected host. Babesiosis should be considered as part of the differential diagnosis in patients from endemic areas presenting with atraumatic splenic rupture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Splenic Rupture as the First Manifestation of Babesia Microti Infection: Report of a Case and Review of Literature

et al. 2018

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“…Treatment specific to underlying etiology for SI is also of paramount importance. Infectious diseases known to be associated with SI also warrant proper treatment, these include infectious mononucleosis, malaria, and babesiosis [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Splenic infarct presenting as acute chest pain

Pak¹,

As²

2017

Vascul Dis Ther

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Splenic infarct (SI) is a rare clinical diagnosis typically characterized by symptoms of abdominal pain, nausea, and vomiting. Here we provide a unique case of SI, presenting as acute left-sided chest pain. This unusual presentation led us to incorrectly focus the initial investigation on diseases of cardiac origin. The resultant delay in correct diagnosis of Splenic Infarct and adequate treatment is described. This case highlights the need to consider SI in patients with acute chest pain, particularly in the presence of predisposing factors, such as hematological malignancy or autoimmune rheumatic diseases.

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“…Esophagogastric devascularisation and splenectomy are performed to reduce venous pressure, vessel calibre and prevent rebleeding. 42,43 However, the intensity of deviation of the hepatic blood flow is responsible for changes in its biochemical markers. A recent study evaluated two groups of patients with hepatosplenic schistosomiasis, one group splenectomized, and the other, non-splenectomized.…”

Section: Schistosomiasismentioning

confidence: 99%

Splenectomy in non-traumatic diseases

Gomes¹,

Soares²,

Coccolini³

et al. 2018

AMJ

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Splenectomy represents the first choice for treatment of spontaneous splenic rupture, abscesses, cysts, tumours, and an alternative for control of hereditary, autoimmune, and myeloproliferative disorders. However, its relative indications have been reviewed for better understanding of both the primary affections and of splenectomy per se, particularly with regard to the immune system. The emergence of minimally invasive surgery, the possibility of splenic preservation, and availability of biological therapy has shown that the procedure has often been referred to as salvage therapy upon failure of other therapeutic propositions. On the other hand, patients have their general health status compromised by the underlying disease, by the use corticosteroids or biologic therapy, immunosuppressed, coagulation disorders, which contribute to the incidence of postoperative complications, such as infections, bleeding and venous thrombosis. Therefore, this scenario favours higher morbidity and mortality rates than those of other intra-abdominal surgical procedures. Thus, this review has the primary and comprehensive objective of purpose the best moment for splenectomy, when surgeons can interfere in the natural course of the disease increasing patients' quality of life and survival. In short, it is desired that the surgeon has complete knowledge of the profound physiological changes imposed on the host. In addition, to distinguish when it is curative and mandatory from when it must be put on hold due to other non-operative treatments with similar outcomes and, lastly, when it is not recommended for not aggregating survival. Key Words Splenectomy, splenomegaly, laparoscopyWhat this review adds: What is known about this subject?The indication of splenectomy in trauma patients is wellestablished; however in non-traumatic diseases it is much more controversial and current review and recommendations is scarce. What new information is offered in this review?This review explores the absolute and relative indications for splenectomy in different clinical sets. It also discourses on pathophysiological changes in an already compromised host. What are the implications for research, policy, or practice?Comprehensive review on the role of splenectomy in different non-traumatic settings, especially, haematological diseases in which it represents a rescue therapy because news biologic therapies.

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Malaria-Induced Splenic Infarction

Cited by 22 publications

References 45 publications

Splenic Rupture as the First Manifestation of Babesia Microti Infection: Report of a Case and Review of Literature

Splenic Rupture as the First Manifestation of Babesia Microti Infection: Report of a Case and Review of Literature

Splenic infarct presenting as acute chest pain

Splenectomy in non-traumatic diseases

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