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DOI: 10.1055/a-2213-1047
Atraumatic splenic rupture – unexpected consequences of a world trip
Atraumatische Milzruptur – ungeahnte Folgen einer Weltreise
Abstract
Diagnostic routine and knowledge about the therapy regimes of infectious diseases like malaria gain in importance due to globalization, global warming, and increasing numbers of refugees. We report a case of a 66-year-old patient who presented with severe abdominal pain, most prominent in the left upper abdomen. He was recently hospitalized with severe falciparum malaria, diagnosed after returning from a trip around the world. Upon readmission, laboratory results showed post-artesunate delayed hemolysis. The ultrasound examination was highly suspicious of splenic rupture, confirmed by the immediately performed CT scan. In this case, the prompt diagnosis allowed the initiation of adequate conservative therapy including intensive care monitoring and hemodynamic stabilization.
Zusammenfassung
Die klinische Relevanz von Infektionskrankheiten wie Malaria wächst auch in der westlichen Welt aufgrund von Globalisierung, globaler Erderwärmung und weltweit zunehmender Fluchtbewegung stetig. In diesem Fall berichten wir von einem 66-jährigen Patienten, der sich mit starken linksseitigen, abdominellen Schmerzen in der Notaufnahme vorstellte. Kurz zuvor war er bei schwerem Verlauf einer Malaria tropica nach Rückkehr von einer Weltreise stationär behandelt worden. Bei Wiedervorstellung zeigte sich laborchemisch das Bild einer Post-Artemisinin-Hämolyse. Der hochgradige sonografische Verdacht auf eine atraumatische Milzruptur ließ sich CT-grafisch bestätigen. Die zeitnahe Diagnosestellung ermöglichte in diesem Fall die Einleitung einer adäquaten, konservativen Therapie inklusive hämodynamischer Stabilisierung und intensivmedizinischer Überwachung.
Keywords
atraumatic splenic rupture - post-artesunate delayed hemolysis - plasmodium falciparum malaria - spleen* Geteilte Erstautorenschaft.
# Geteilte Letztautorenschaft.
Publication History
Received: 02 November 2023
Article published online:
25 June 2024
© 2024. Thieme. All rights reserved.
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