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Extract

During acute and chronic malaria, there are changes in splenic structure and function that can result in either an asymptomatic enlargement or a wide variety of complications. Physicians are usually aware of the complications caused by Plasmodium falciparum malaria, but they are less familiar with the complications of Plasmodium vivax malaria. As an example, distress respiratory syndrome has recently been described in the course of P vivax malaria, most frequently after treatment instauration.1 Splenic rupture, though a rare complication of P vivax malaria, can be a life‐threatening event. Historically, splenectomy has been the treatment of choice in cases of spontaneous rupture of the spleen, but due to recognition of complications of this practice, new conservative strategies are considered in selected cases. We present a case of splenic rupture in a traveler that was successfully treated with a conservative approach.

Case report

A 34‐year‐old patient had traveled to Indonesia for 1 month (visiting the islands of Sumatra, Java, Kalimantan, and northern region of Sulawesi), without taking malaria prophylaxis. He presented to the emergency department because of a 4‐day history of fever, with onset 24 hours after return. He was diagnosed with noncomplicated malaria due to P vivax (parasitemia 1%). Treatment with cloroquine (25 mg/base/kg) was prescribed, and the patient was discharged. The next day he returned to hospital because of sudden onset of upper left quadrant pain.

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Brief Communications
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