It’s never too late- spontaneous rupture of spleen and life-threatening hypovolemic shock in a patient recuperating from legionnaire’s disease

Vol 7 | Issue 2 | May-August 2021 | Page: 06-09 | Naveen Yadav, Krishnaswamy Sundararajan


Author: Naveen Yadav [1], Krishnaswamy Sundararajan [1]

[1] Intensive Care Unit, Level 4, Royal Adelaide Hospital and The University of Adelaide, Port Road, Adelaide, South Australia 5000.

Address of Correspondence
Dr. Naveen Yadav
Royal Adelaide hospital Port Road, Adelaide, South Australia. 5000
E-mail: nyadav01@sa.gov.au.


It’s never too late- spontaneous rupture of spleen and life-threatening hypovolemic shock in a patient recuperating from legionnaire’s disease


Abstract

Spontaneous non-traumatic rupture of the spleen in the setting of Legionnaires’ disease is very uncommon but a life-threatening condition. The splenic rupture can present within a few days after symptom onset with significant hypotension with drop in haemoglobin along with left side upper quadrant pain. Most of the cases described in the previous literature have presented within 0-11 (mean 4) days of the pneumonia but this case we are reporting presented after 3 weeks after being treated with Legionella pneumonia. The case also highlights an atypical presentation and emphasises the need to maintain a low threshold for diagnosis especially in resource constrained setting so that patient can be transferred at the earliest to a centre where appropriate corrective measures including surgery can be safely undertaken.
Keywords: splenic rupture, pneumonia, hypovolemic shock.


References

1. Hyun BM, Varga CF, Rubin RJ. Spontaneous and pathologic rupture of the spleen. Arch Surg 1972; 104:652-7.
2. Brown RB. Legionella pneumonia: The spectrum continues to expand. Chest 2004; 125:1979-80.
3. Holmes AH, Ng VW, Fogarty P. Spontaneous rupture of the spleen in Legionnaires’ disease. Postgrad Med J 1990; 66:876-7.
4. Saura P, Valles J, Jubert P, Ormaza J, Segura F. Spontaneous rupture of the spleen in a patient with legionellosis. Clin Infec Dis 1993; 17:298.
5. Domingo P, Rodríguez P, Lopez-Contreras J, Rebasa P, Mota S, Matias-Guiu X. Spontaneous rupture of the spleen associated with pneumonia. Eur J Clin Microbiol Infect Dis 1996; 15:733-6.
6. Roig J, Rello J, Yue VL. Légionnaires’ disease : A guide to diagnosis and therapy. J Respir Dis 2002; 23:229-34.
7. Heath GH, Grove DI, Looke DFM. Delay in appropriate therapy of Legionella pneumonia associated with increase in mortality. Eur J Clin Microb Infect Dis 1996; 15:286-90.
8. Gupta SK, Imperiale TF, Sarosi GA. Evaluation of the Winthrop University Hospital criteria to identify Legionella pneumonia. Chest 2001; 120:1064-71.
9. Weisenburger DD, Helms CM, Renner ED. Sporadic Legionnaires’ disease. A pathologic study of 23 fatal cases. Arch Pathol Lab Med 1981; 105:130-7.
10. M Casnova-Roman, J Casas, A samchez-Porto, B Nacle. Spontaneous rupture of the spleen associated with Legionella Pneumonia. Can J Infect Dis Med Microbiol 201;21(3): e107-e108.


How to Cite this Article: Yadav N, Sundararajan K | It’s never too late- spontaneous rupture of spleen and lifethreatening hypovolemic shock in a patient recuperating from legionnaire’s disease | Journal of Anaesthesia and Critical Care Case Reports | May-August 2021; 7(2): 06-09.

(Abstract) (Text HTML) (Download PDF)