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Splenomegaly with multiple splenic infarcts due to malaria

By Dr.Pavan Kumar In OTHERS Posted October 6, 2018

Patient History : A 26 year old lady presented with fever with chills on and off since 4-5 days with abdominal pain. Her hematological parameters are as follows :- Hb - 5.1 g% ; Platelet count - 3.2 lac/cumm; ESR - 75 mm at the end of one hour; WBC - 6,600 /cmm DLC - P55 L45; PS for Malarial parasite - Malarial parasite seen
Gender:Female
Age:26

Splenomegaly with multiple splenic infarcts due to malaria ( P. Falciparum- in the above case )

Malaria is the most common among the parasitic disease.

Plasmodium falciparum is deadliest species, may develop severe life threatening complications culminating in failure of various organ systems. Of all complications of malaria splenic infarction is a rare one.

The pathophysiology behind splenic infarction is the phenomenon of sequestration of red cells containing the mature form of the parasite. Sequestration occurs predominantly in the venules of the vital organs. It is not distributed uniformly throughout the body, being greatest in the brain, particularly in the white matter, prominent in the heart, eyes, kidney, intestines, adipose tissues and least in the skin. Spleen act as a principal host defense against malarial parasites by destroying and filtering of both parasitised and uninfected erythrocytes. That\'s why sequestered parasites develops out of the reach of the principal host defense, i.e. spleen. So there is accumulation of malarial parasite in spleen causing splenic infarction.

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