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Fulltext Spontaneous splenic rupture in Plasmodium knowlesi malaria

Chang CY, Pui WC, Kadir KA, Singh B

Malar J, 2018 Dec 04;17(1):448.
PMID: 30509259 DOI: 10.1186/s12936-018-2600-2

BACKGROUND: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria.
CASE PRESENTATION: A 46-year-old man presented with fever and acute surgical abdomen with concomitant P. knowlesi malaria infection at Kapit Hospital. He was in compensated shock upon arrival to the hospital. He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fluid in the abdomen. He underwent emergency exploratory laparotomy in view of haemodynamic instability and worsening peritonism. Intraoperatively, haemoperitoneum and bleeding from the spleen was noted. Splenectomy was performed. Histopathological examination findings were suggestive of splenic rupture and presence of malarial pigment. Analysis of his blood sample by nested PCR assays confirmed P. knowlesi infection. The patient completed a course of anti-malarial treatment and recovered well post-operation.
CONCLUSIONS: Spontaneous splenic rupture is a rare complication of malaria. This is the first reported case of splenic rupture in P. knowlesi malaria infection. Detection of such a complication requires high index of clinical suspicion and is extremely challenging in hospitals with limited resources.

Matched MeSH terms: Spleen/parasitology
Further stages of the "sporozoan" from the moon rat Echinosorex gymnurus, and its possible connection with Sarcocystis

Dissanaike AS, Lim BL, Poopalachelvam M

Southeast Asian J. Trop. Med. Public Health, 1974 Sep;5(3):456-7.
PMID: 4215149
Matched MeSH terms: Spleen/parasitology
A case of severe Plasmodium knowlesi in a splenectomized patient

Boo YL, Lim HT, Chin PW, Lim SY, Hoo FK

Parasitol Int, 2016 Feb;65(1):55-57.
PMID: 26454133 DOI: 10.1016/j.parint.2015.10.003

Plasmodium knowlesi, a zoonotic malaria, is now considered the fifth species of Plasmodium causing malaria in humans. With its 24-hour erythrocytic stage of development, it has raised concern regarding its high potential in replicating and leading to severe illness. Spleen is an important site for removal of parasitized red blood cells and generating immunity. We reported a case of knowlesi malaria in a non-immune, splenectomized patient. We observed the delay in parasite clearance, high parasitic counts, and severe illness at presentation. A thorough search through literature revealed several case reports on falciparum and vivax malaria in splenectomized patients. However, literature available for knowlesi malaria in splenectomized patient is limited. Further studies need to be carried out to clarify the role of spleen in host defense against human malaria especially P. knowlesi.

Matched MeSH terms: Spleen/parasitology
Hepatosplenic lesions induced by experimental Schistosoma malayensis in rabbits

Shekhar KC, Pathmanathan R

Southeast Asian J. Trop. Med. Public Health, 1993 Jun;24(2):333-9.
PMID: 8266238

Two groups of three rabbits each were infected with 250 cercariae of the Baling and Koyan strain of Schistosoma malayensis. Changes induced by both strains included periportal hepatocellular necrosis and fibrosis. Vascular changes such as portal phlebitis and thrombophlebitis and varying degrees of pericholangitis were also present. Amyloid deposition was noted. A comparative study of the changes induced in rabbits by S. malayensis, S. mekongi and S. japonicum showed that the hepatic lesions induced by the Baling strain of S. malayensis were similar to that induced by S. japonicum, and were more severe than that induced by S. mekongi or the Koyan strain.

Matched MeSH terms: Spleen/parasitology
Myxozoan pathogens in cultured Malaysian fishes. I. Myxozoan infections of the sutchi catfish Pangasius hypophthalmus in freshwater cage cultures

Molnár K, Székely C, Mohamed K, Shaharom-Harrison F

Dis Aquat Organ, 2006 Mar 2;68(3):209-18.
PMID: 16610586

Cage-cultured sutchi catfish Pangasius hypophthalmus (Sauvage, 1878), a favourite food fish in Southeast Asia, proved to be infected by 6 myxozoan species. Three species belonged to the genus Hennegoides (H. berlandi, H. malayensis, and H. pangasii), 1 to Henneguya (H. shariffi) and 2 to Myxobolus (M. baskai, and M. pangasii). Five myxozoans infected the gills and 1 was found on the spleen. Myxozoans infecting the gills were characterised by a specific site selection. H. shariffi sp. n. and H. berlandi sp. n. formed plasmodia in the multi-layered epithelium of the gill filaments. Of the 2 vascular species H. pangasii sp. n. developed in the gill arteries, while M. baskai sp. n. infected the capillary network of the gill lamellae. Plasmodia of H. malayensis sp. n. were found inside the cartilaginous gill rays of the filaments. Large plasmodia of M. pangasii sp. n. were located in a groove of the spleen but they affected only the serosa layer covering the spleen.

Matched MeSH terms: Spleen/parasitology
Fulltext Rheopathologic Consequence of Plasmodium vivax Rosette Formation

Zhang R, Lee WC, Lau YL, Albrecht L, Lopes SC, Costa FT, et al.

PLoS Negl Trop Dis, 2016 08;10(8):e0004912.
PMID: 27509168 DOI: 10.1371/journal.pntd.0004912

Malaria parasites dramatically alter the rheological properties of infected red blood cells. In the case of Plasmodium vivax, the parasite rapidly decreases the shear elastic modulus of the invaded RBC, enabling it to avoid splenic clearance. This study highlights correlation between rosette formation and altered membrane deformability of P. vivax-infected erythrocytes, where the rosette-forming infected erythrocytes are significantly more rigid than their non-rosetting counterparts. The adhesion of normocytes to the PvIRBC is strong (mean binding force of 440pN) resulting in stable rosette formation even under high physiological shear flow stress. Rosetting may contribute to the sequestration of PvIRBC schizonts in the host microvasculature or spleen.

Matched MeSH terms: Spleen/parasitology
Histopathology of cultured sea bass (Lates calcarifer) (Centropomidae) infected with Cruoricola lates (Trematoda: Sanguinicolidae) from Pulau Ketam, Malaysia

Herbert BW, Shaharom FM, Anderson IG

Int J Parasitol, 1995 Jan;25(1):3-13.
PMID: 7797370

Cruoricola lates are found throughout sea bass (Lates calcarifer), most commonly in the mesenteric blood vessels, kidney, pericardial vessels, and eye. Eggs of C. lates were predominantly found in the gills, ventricle, hepatopancreas, and kidneys, but only develop to miracidia regularly in the gills and heart. Single miracidia escaping appear to cause little damage, but groups induce an inflammatory response and haemorrhage. Endocardial macrophages encapsulate eggs trapped between trabeculae in the heart. The reaction to eggs in the kidneys, hepatopancreas and spleen consists of fibrocytic encapsulation. Infection at the levels observed in this study were insufficient to cause lethal pathological changes, but could result in reduced food conversion ratios or impaired immunological capacity.

Matched MeSH terms: Spleen/parasitology