Spontaneous splenic rupture: A rare complication of concurrent malaria and dengue infections - A case report

Abstract

Introduction: Spontaneous splenic rupture (SSR) is a rare, life-threatening complication, sometimes associated with infections like malaria and dengue fever. This case report details a unique presentation of SSR.

Case presentation: A 28-year-old male in Somalia presented with fever, epigastric pain, nausea, vomiting, and body aches, consistent with malaria and dengue. Following self-discharge after initial malaria treatment, his condition deteriorated rapidly, leading to severe abdominal pain and hypotension. Laboratory tests confirmed malaria and dengue, with low hemoglobin. A CT scan revealed a large hemoperitoneum and splenic rupture requiring emergency laparotomy and splenectomy. Post-operative recovery was uneventful.

Discussion: This case highlights the diagnostic challenges posed by overlapping symptoms of malaria and dengue, potentially masking SSR. The concurrent infections likely contributed to splenomegaly, increasing rupture risk. While SSR has been linked to malaria or dengue individually, this case suggests a potential synergistic effect of co-infection. The patient's self-discharge emphasizes the importance of patient education and treatment adherence. Successful surgical intervention underscores the critical role of prompt medical care.

Conclusion: This is the first reported case of SSR secondary to concurrent Plasmodium falciparum malaria and dengue fever in Somalia. This highlights the need for improved diagnostic tools, healthcare infrastructure, and targeted public health interventions in endemic regions. Further research is crucial to understand the synergistic effect of these co-infections in inducing SSR.

Keywords: Co-infection; Diagnostic challenges; Resource-limited settings; Splenectomy; Spontaneous splenic rupture.