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Subcapsular Splenic Hemorrhage in Vivax Malaria

Korean Journal of Parasitology 2019년 57권 4호 p.405 ~ 409
 ( Im Jae-Hyoung ) - Inha University School of Medicine Department of Internal Medicine

 ( Chung Moon-Hyun ) - Seogwipo Medical Center Department of Internal Medicine
 ( Durey Areum ) - Inha University School of Medicine Departments of Emergency Medicine
 ( Lee Jin-Soo ) - Inha University School of Medicine Department of Internal Medicine
 ( Kim Tong-Soo ) - Inha University School of Medicine Department of Tropical Medicine and Parasitology
 ( Kwon Hea-Yoon ) - Inha University School of Medicine Department of Internal Medicine
 ( Baek Ji-Hyeon ) - Inha University School of Medicine Department of Internal Medicine

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.

키워드

Plasmodium vivax; hemorrhage; malaria; spleen; splenic rupture
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