| Autor: |
S, Falk, H, Protz, U, Köbrich, H J, Stutte |
| Jazyk: |
němčina |
| Rok vydání: |
1992 |
| Předmět: |
|
| Zdroj: |
Deutsche medizinische Wochenschrift (1946). 117(22) |
| ISSN: |
0012-0472 |
| Popis: |
A 44-year-old man developed bouts of fever (up to 40 degrees C) seven days after returning from a holiday in Kenya. Malaria prophylaxis with chloroquine had been correctly undertaken. Concentrations of lactate dehydrogenase and total bilirubin were raised (493 U/l and 3.55 mg/dl, respectively). Blood smear revealed the ring forms of Plasmodium falciparum. Thereupon the patient was given mefloquine in decreasing doses (750/500/250 mg) at intervals of 8 hours. The following night he had a circulatory collapse and complained of pain on pressure, especially in the left upper abdomen. Abdominal sonography showed a slightly enlarged spherical spleen with an echo-poor band and fluid collection in the rectovesicular pouch, indicating rupture of the spleen. A splenectomy was performed. Subsequently the number of malaria organisms in the blood smear gradually fell and signs of haemolysis disappeared. Splenic rupture is a very rare complication of acute malaria. It is presumably caused by marked stasis in the splenic sinuses with deformed parasite-containing red blood cells. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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