Spontaneous spleen rupture in the course of malaria

The spontaneous rupture of malarial spleen is an uncommon complication. It usually occurs to a child and a recent expatriate. Its diagnosis is misleading into a context of infection. A 28-year-old European man, newly affected to Gabon, under chimioprophylactic drugs by chloroquine and proguanil, has been hospitalized in September 2000 because of an acute attack of malaria to Plasmodium falciparum. After four days treatment by quinine, he presented an abdominal pain with a Sub capsular Haematoma of the spleen confirmed by Scanner. The evolution was favourable under conservative treatment. The spontaneous rupture of malarial spleen is caused by Plasmodium vivax and falciparum. Twenty cases are reported in the literature. Conservative management permits to preserve the role of the spleen in immune response especially of the child and of people who regularly travel to endemic zone. (c) 2007 Elsevier Masson SAS. Tons droits reserves.