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Malaria, Sickle Cell Trait, Splenic Infarction
The protective role of 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, rarely associated with malaria. A Nigerian boy was admitted to our ward after returning from his country of origin, for P. falciparum malaria. He underwent abdominal US for upper right abdominal pain, showing cholecystitis and multiple splenic abscesses. Empiric antibiotic therapy was undertaken. Bartonella, Echinococcus, Entamoeba serologies, blood cultures, Quantiferon test, coproparasitologic 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 made.
Splenic infarction should be taken into account in patients with malaria and localized abdominal pain. Moreover, diagnosis of SCT should be considered.
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