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Tropical Splenomegaly Syndrome Treatment & Management

  • Author: Mundeep K Kainth, DO, MPH; Chief Editor: Robert J Arceci, MD, PhD  more...
Updated: Oct 09, 2015

Medical Care

Therapy is based on the use of antimalarial drugs. A literature review by Leoni et al indicated that a short therapy course is sufficient treatment for HMS in patients who, after exposure to malaria parasites, do not revisit areas where malaria is endemic. In such patients, according to the study, elimination of the infection effectively cures the splenomegaly. The investigators, who drew data from 89 papers, asserted that patients who continue to be exposed to malaria-endemic regions require intermittent therapy or possibly lifelong treatment.[29]


Surgical Care

Splenectomy plays no role in the treatment of hyperreactive malarial syndrome (HMS) and should be avoided as it can result in fulminant and overwhelming infections with high mortality.



Appropriate consultation with oncologists and metabolic and infectious disease specialists may be sought to rule out diseases that mimic hyperreactive malarial syndrome (HMS).



Activity is permitted, as tolerated by the patient. A patient's activity may be limited because of severe anemia or the pressure effects of massive splenomegaly.

Contributor Information and Disclosures

Mundeep K Kainth, DO, MPH City Medical Specialist, Bureau of School Health, Division of Family and Child Health, New York City Department of Health and Mental Hygiene; General Pediatrician, Island Pediatric Associates

Mundeep K Kainth, DO, MPH is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.


Mudra Kumar, MD, MRCP, FAAP Professor of Pediatrics, Course Director, Course 6 MSII, Preclerkship Director, Clinical Integration, Department of Pediatrics, University of South Florida Morsani College of Medicine

Mudra Kumar, MD, MRCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Society of Hematology, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Vikramjit S Kanwar, MBBS, MBA, MRCP(UK), FAAP Professor of Pediatrics, Albany Medical College; Chief, Division of Pediatric Hematology-Oncology, John and Anna Landis Endowed Chair for Pediatric Hematology-Oncology, Medical Director, Melodies Center for Childhood Cancer and Blood Disorders, Albany Medical Center

Vikramjit S Kanwar, MBBS, MBA, MRCP(UK), FAAP is a member of the following medical societies: American Academy of Pediatrics, American Society of Hematology, American Society of Pediatric Hematology/Oncology, Children's Oncology Group, International Society of Pediatric Oncology

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

James L Harper, MD Associate Professor, Department of Pediatrics, Division of Hematology/Oncology and Bone Marrow Transplantation, Associate Chairman for Education, Department of Pediatrics, University of Nebraska Medical Center; Associate Clinical Professor, Department of Pediatrics, Creighton University School of Medicine; Director, Continuing Medical Education, Children's Memorial Hospital; Pediatric Director, Nebraska Regional Hemophilia Treatment Center

James L Harper, MD is a member of the following medical societies: American Society of Pediatric Hematology/Oncology, American Federation for Clinical Research, Council on Medical Student Education in Pediatrics, Hemophilia and Thrombosis Research Society, American Academy of Pediatrics, American Association for Cancer Research, American Society of Hematology

Disclosure: Nothing to disclose.

Chief Editor

Robert J Arceci, MD, PhD Director, Children’s Center for Cancer and Blood Disorders, Department of Hematology/Oncology, Co-Director of the Ron Matricaria Institute of Molecular Medicine, Phoenix Children’s Hospital; Editor-in-Chief, Pediatric Blood and Cancer; Professor, Department of Child Health, University of Arizona College of Medicine

Robert J Arceci, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Association for Cancer Research, American Pediatric Society, American Society of Hematology, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Additional Contributors

J Martin Johnston, MD Associate Professor of Pediatrics, Mercer University School of Medicine; Director of Hematology/Oncology, The Children's Hospital at Memorial University Medical Center; Consulting Oncologist/Hematologist, St Damien's Pediatric Hospital

J Martin Johnston, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Pediatric Hematology/Oncology, International Society of Paediatric Oncology

Disclosure: Nothing to disclose.

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Young patient with hepatomegaly and massive splenomegaly.
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