# name
Sudden spleen rupture in a Plasmodium vivax-infected patient
                undergoing malaria treatment

# metadata.dc.description.abstract[].value
BACKGROUND: Splenomegaly is one of the most common features of
                malaria. However, spontaneous splenic rupture, although unusual,
                represents a severe complication often leading to death. It is
                mostly seen in acute infection and primary attack, and it is
                most commonly associated with Plasmodium vivax. Here, a case of
                spontaneous splenic rupture diagnosed with a portable ultrasound
                apparatus shortly after starting treatment and with recurrent
                parasitaemia after splenectomy, is reported. CASE DESCRIPTION:
                In November 2015, a 45-year-old Brazilian man presented to the
                hospital in Manaus with fever, headache and myalgia. He was
                diagnosed with P. vivax malaria and, after a normal G6PD test,
                he started treatment with chloroquine and primaquine and was
                discharged. Two days later, he went back to the hospital with
                abdominal pain, dyspnea, dry cough, pallor, oliguria and fever.
                Using a portable ultrasound, he was diagnosed of rupture of the
                spleen, which was removed by emergency surgery. After this
                episode, he suffered two more malaria episodes with high
                parasitaemia at approximately 2-month intervals. DNA from
                different portions of the spleen was extracted and a qualitative
                PCR was performed to detect P. vivax. CONCLUSIONS: The splenic
                rupture suffered by this patient occurred 2 days after starting
                the treatment. Having a portable ultrasound apparatus may have
                saved the patient's life, as it revealed a haemorrhage needing
                an urgent surgery. Parasites were detected by PCR in the
                extracted spleen. This patient suffered two more vivax malaria
                diagnosed episodes in spite of receiving and completing
                treatment with chloroquine and primaquine for each clinical
                attack. Splenic rupture during acute malaria is uncommon, but it
                is likely underdiagnosed and underreported, because the lack of
                means and equipment hinders diagnostic confirmation, especially
                in endemic areas.

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Sudden spleen rupture in a Plasmodium vivax-infected patient
                undergoing malaria treatment