Department of Infectious and Tropical Diseases, University of Brescia
and Spedali Civili General Hospital, Brescia, Italy.
2 University Department of Pediatrics, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.
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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.
|Figure 1. Fever chart during the admittance in the Infectious Diseases ward.|
|Figure 2 and 3. Abdomen magnetic resonance imaging (T1 and T2 weighted, respectively): Splenic focal areas of signal alteration, with prevalent peripheral subcapsular distribution.|
Discussion and Conclusions