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      Spontaneous Splenic Rupture in an Ill Returned Traveller

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          Abstract

          Spontaneous splenic rupture is a known, but rare and possibly fatal, complication of different infectious diseases. We present a case of a 38-year-old male patient who presented with fever, icterus and spontaneous splenic rupture after a visit to Vietnam and discuss the differential diagnosis of splenic rupture in ill returned travellers.

          LEARNING POINTS

          • Spontaneous splenic rupture is a rare complication of several tropical diseases, including Salmonella infection.

          • Atypical presentations of Salmonella infection should always be considered in febrile ill returned travellers.

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          Most cited references16

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          Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections.

          John Crump, Maria Sjölund-Karlsson, Melita Gordon … (2015)
          Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica, initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015.
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            Splenic rupture in infectious mononucleosis: A systematic review of published case reports

            A. BARTLETT, R. Williams, M. Hilton (2016)
            Article 0 comments Cited 19 times – based on 0 reviews     Review now
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              A fatal case of spontaneous rupture of the spleen due to dengue virus infection: case report and review.

              Apatcha Pungjitprapai, Terapong Tantawichien (2008)
              Dengue hemorrhagic fever (DHF) is being seen more frequently in adults as a consequence of shifting patterns of infection and immunity and there has been an apparent increase in the complications of dengue infection. Spontaneous splenic ruptures are rare but life-threatening complications of infectious diseases. We describe a fatal case of spontaneous splenic rupture in an adult patient with DHF. A case of spleen rupture may be misdiagnosed as shock syndrome. Physicians should be aware of the possibility of splenic rupture in areas where dengue infection is endemic. Early diagnosis and treatment of splenic rupture should improve clinical outcomes.
              Article 0 comments Cited 7 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Eur J Case Rep Intern Med
                Title: European Journal of Case Reports in Internal Medicine
                Publisher: SMC Media Srl
                ISSN (Electronic): 2284-2594
                Publication date Collection: 2020
                Publication date (Electronic): 18 September 2020
                Volume: 7
                Issue: 12
                Electronic Location Identifier: 001891
                Affiliations
                [1 ]Internal Medicine, Rijnstate Ziekenhuis, Arnhem, the Netherlands
                [2 ]Microbiology Department, Rijnstate Ziekenhuis, Arnhem, the Netherlands
                Article
                Publisher ID: 1891-1-16418-1-10-20200917
                DOI: 10.12890/2020_001891
                PMC ID: 7727630
                SO-VID: e1cd1039-ce2c-4eac-9c79-63e34bc593e5
                Copyright © © EFIM 2020
                License:

                This article is licensed under a Commons Attribution Non-Commercial 4.0 License

                History
                Date received : 16 July 2020
                Date accepted : 19 July 2020
                Categories
                Subject: Articles

                Keywords: salmonella,fever,spleen,rupture,spontaneous
                Data availability:
                Keywords: salmonella, fever, spleen, rupture, spontaneous

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