title: A Strange Manifestation of Malaria in a Native Nigerian Boy.
abstract: The protective role of Sickle Cell Trait (SCT) in malaria endemic areas has been proved, and prevalence of HbS gene in malaria endemic areas is high. Splenic infarction is a well-known complication of SCT, while the association with malaria is considered rare. A Nigerian boy was admitted to our ward after returning from his country of origin, forP. falciparummalaria. He underwent abdominal ultrasound for upper right abdominal pain, showing cholecystitis and multiple splenic lesions suggestive of abscesses. Empiric antibiotic therapy was undertaken.Bartonella,Echinococcus,Entamoebaserologies, blood cultures, Quantiferon test, copro-parasitologic exam were negative; endocarditis was excluded. He underwent further blood exams and abdomen MRI, confirming the presence of signal alterations areas, with radiographic appearance of recent post-infarction outcomes. Hemoglobin electrophoresis showed a percentage of HbS of 40.6% and a diagnosis of SCT was then made. Splenic infarction should be taken into account in patients with malaria and localized abdominal pain. Moreover, diagnosis of SCT should be considered.
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Magro
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Izzo
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Saccani
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Casari
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Caligaris
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Lina Rachele
authors.initials: LR
authors.lastname: Tomasoni
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Matteelli
authors.affiliation: University Department of Pediatrics, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Lombardi
authors.affiliation: University Department of Pediatrics, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Meini
authors.affiliation: University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
keywords: Malaria; Sickle Cell Trait; Splenic Infarction