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Malaria and splenic rupture — DTM&H MCQ

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ModerateMalariaMalaria and splenic ruptureDTM&H

A 32-year-old man treated for Plasmodium vivax malaria 4 days ago develops sudden left upper quadrant pain and syncope. He has hypotension and a tender enlarged spleen. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Splenic rupture complicating malaria

Splenic rupture complicating malaria is the single best answer because acute abdominal pain and shock in a patient with malaria and splenomegaly should prompt concern for splenic rupture. Acute pancreatitis is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that vivax malaria is often considered benign but can cause severe complications.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026