Pathology of the ruptured spleen in acute vivax malaria.

D ESPITE the fact that malaria is a worldwide disease involving millions of individuals, and considering the large number of cases seen in military service, spontaneous rupture of the spleen is actually a rare occurrence. Seventy-two cases were accumulated by Leighton prior to 1917 and 64 cases have been reported subsequent to this date.’ Studies of the pathology of malaria are of importance in those parts of the world where malaria is prevalent. Previous pathologic descriptions of the spleen in acute tertian malaria in man have been sketchy. Furthermore, the mechanisms underlying the rupture have not been adequately studied. A pathologic description of the spleen in 4 cases of acute tertian malaria is therefore pertinent even though the incidence of malarial attacks and possibility of splenic rupture is rapidly decreasing. In 3 of the 4 cases under consideration, spontaneous rupture had occurred. The fourth case was that of a subcapsular hemorrhage, presumably just prior to rupture. All cases were successfully operated with splenectomy.