Malaria-associated splenic haemorrhage requiring emergency splenectomy: a rare complication managed in a resource-constrained setting

Falciparum malaria and Vivax malaria are notorious for the development of multiple complications, including acute kidney injury, acute liver injury, severe hemolysis, bone marrow suppression, severe acidosis, hypoglycemia and CNS complications. We hereby present two cases of rare complications associated with Malaria, which were managed in a resource-constrained setting in Eastern Africa. Two individuals working in the malaria endemic region of South Sudan were detected with Mixed Plasmodium falciparum-Plasmodium vivax when they reported to the hospital with acute febrile illness for two days. They were noted to have palpable hepatosplenomegaly. Both patients suffered spontaneous rupture of the spleen, leading to gross hemoperitoneum and hemodynamic instability. They were taken up for an emergency explorative laparotomy as a life-saving measure. Of the two patients, one survived following timely surgical intervention and supportive care, whereas the other succumbed despite emergency management.