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Case Reports
. 2017 Mar 1;9(1):e2017023.
doi: 10.4084/MJHID.2017.023. eCollection 2017.

A Strange Manifestation of Malaria in a Native Nigerian Boy

Paola Magro  1 , Ilaria Izzo  1 , Barbara Saccani  1 , Salvatore Casari  1 , Silvio Caligaris  1 , Lina Rachele Tomasoni  1 , Alberto Matteelli  1 , Annamaria Lombardi  2 , Antonella Meini  2 , Francesco Castelli  1
Affiliations
Case Reports

A Strange Manifestation of Malaria in a Native Nigerian Boy

Paola Magro et al. Mediterr J Hematol Infect Dis. .

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, for P. falciparum malaria. 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, Entamoeba serologies, 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.

Keywords: Malaria; Sickle Cell Trait; Splenic Infarction.

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Figures

Figure 1
Figure 1
Fever chart during the admittance in the Infectious Diseases ward.
Figure 2 and 3
Figure 2 and 3
Abdomen magnetic resonance imaging (T1 and T2 weighted, respectively): Splenic focal areas of signal alteration, with prevalent peripheral subcapsular distribution.
See this image and copyright information in PMC

Comment in

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