Abouzahir A, Bouchama R
Service de Médecine Interne, 5e Hôpital Militaire, Guelmim, Morocco.
Med Mal Infect. 2008 Mar;38(3):153-5. doi: 10.1016/j.medmal.2007.10.004. Epub 2008 Feb 20.
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.
疟疾性脾自发性破裂是一种罕见的并发症。它通常发生在儿童和近期归国的侨民身上。其诊断在感染背景下具有误导性。一名28岁的欧洲男子,刚到加蓬,正在服用氯喹和氯胍进行化学预防,2000年9月因恶性疟原虫急性疟疾发作而住院。用奎宁治疗四天后,他出现腹痛,经扫描证实有脾包膜下血肿。在保守治疗下病情好转。疟疾性脾自发性破裂由间日疟原虫和恶性疟原虫引起。文献报道了20例。保守治疗有助于保留脾脏在免疫反应中的作用,尤其是对儿童和经常前往流行地区的人。