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