Hyper-Reactive Malarial Splenomegaly Syndrome (HMS): Management Challenges in a Rural Community in Southwest Nigeria – Case Report

Hyper-reactive malarial Splenomegaly Syndrome (HMS) is a condition with multifaceted etiopathogenesis. Some authorities believe it is linked to reticuloendothelial hyperplasia from repeated bombardments by malaria IgM complexes. Here we present a 14-year old boy found with a massive spleen during a community malaria survey. He had no formal education and lived in a swampy area with his grandmother. He was pale, icteric, and undernourished. He was administered acute antimalarial therapy, malaria prophylaxis and followed up for 18 months. He showed remarkable improvement with his massive spleen receding and was enrolled into school, but compliance with medication, schooling, and relocating from a swampy home was challenging.