A Unique Case of Nonhypoxic Splenic Infarction in a Patient With Sickle Cell Trait Due to Dehydration and Sepsis From...

Splenic infarction is a recognized complication occurring at high altitudes in patients with sickle cell trait (SCT). There have been a few cases of splenic infarction occurring in the setting of nonhypoxic events at sea level, and some cases of spontaneous splenic infarction without an inciting event in patients with SCT. We present the case of a 25-year-old male with a recent untreated dental infection who was drinking alcohol excessively and moving furniture over the last few weeks. He came to the hospital due to left-sided abdominal pain and was found to have a splenic infarction. He was found to have hemolysis on his blood work, with elevated lactate dehydrogenase, low haptoglobin, and elevated bilirubin levels. He underwent hemoglobin electrophoresis which revealed SCT. His blood cultures grew Streptococcus mitis and Streptococcus oralis, a normal oral commensal, which was thought to be due to the untreated dental infection. His workup for endocarditis as a source of splenic infarction was negative, and he had no other source of emboli. He was treated with antibiotics for the sepsis and fluids for the sickling and hemolysis. He developed multiple complications of the splenic infarction but ultimately recovered. Ours is the first example of nonhypoxic splenic infarction in an SCT patient that has been documented in a scenario of dehydration and sepsis. This link should be understood to prevent splenic infarction even at sea level by preventing overexertion and dehydration in individuals with known SCT.