Nescient aetiology of splenic laceration – An enigma unveiled

Malaria is a common endemic disease prevalent in developing countries like India that presents with wide spectrum of clinical symptoms and complications. Splenic rupture is an uncommon but life-threatening complication which can be either spontaneous or as a result of trauma. We present a case of 50-year-old man with left upper quadrant pain following a polytrauma. Based on the radiological evidence of laceration and rupture of markedly enlarged spleen, emergency splenectomy was performed. Postoperative haematological evaluation established the co-infection of Plasmodium falciparum and vivax with high parasitaemia and marked thrombocytosis. The incidences of splenic rupture due to malaria are under-reported. In endemic areas, the management of splenic rupture in malaria should be focused on splenic preservation, thereby reducing the risk of future attacks of malaria in those patients who are highly susceptible to Plasmodium species and also reducing the incidence of overwhelming sepsis.