Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Subcapsular Splenic Hemorrhage in Vivax Malaria

  • Im, Jae Hyoung (Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine) ;
  • Chung, Moon-Hyun (Department of Internal Medicine, Seogwipo Medical Center) ;
  • Durey, Areum (Department of Emergency Medicine, Inha University School of Medicine) ;
  • Lee, Jin-Soo (Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine) ;
  • Kim, Tong-Soo (Department of Tropical Medicine, Inha University School of Medicine) ;
  • Kwon, Hea Yoon (Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine) ;
  • Baek, Ji Hyeon (Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine)
  • Received : 2019.04.27
  • Accepted : 2019.08.05
  • Published : 2019.08.31
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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.

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References

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