title: Splenic infarction during acute malaria.
abstract: Malaria is the most frequent cause of fever among travellers returning from tropical countries. Each year about 7000 cases are notified in France, of which 90% are due to Plasmodium falciparum. We describe the case of a Caucasian female patient with no previous exposure to malaria in whom splenic infarction occurred during effective antimalarial treatment for initially uncomplicated acute malaria. Management was restricted to close clinical monitoring and analgesia (subcutaneous morphine). Imaging abnormalities resolved within a few months. We found seven other such cases in the literature. All seven patients were younger and splenic infarction occurred later than in the case we describe. Clinical outcome was favourable in all the cases. It is noteworthy that this rare complication can occur despite appropriate antimalarial prophylaxis and treatment. There are no known predictive signs. Clinicians must be aware that left hypochondrial pain occurring during treatment for acute malaria may be due to splenic infarction.
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Université Pierre et Marie Curie, Hôpital Tenon (AP-HP), 4 rue de la Chine, 75020 Paris, France. philippe.bonnard@tnn.ap-hop-paris.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Bonnard
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guiard-Schmid
authors.forename: Michel
authors.initials: M
authors.lastname: Develoux
authors.forename: Willy
authors.initials: W
authors.lastname: Rozenbaum
authors.forename: Gilles
authors.initials: G
authors.lastname: Pialoux
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011803:Quinine / Q000008:administration & dosage; D013159:Splenic Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000962:Antimalarials; D011803:Quinine