Treatment of choice for tropical splenomegaly is
**Core Concept**
Tropical splenomegaly syndrome (TSS), also known as hyper-reactive malarial splenomegaly, is a condition characterized by massive splenomegaly, often associated with chronic malaria infection. The treatment of choice for TSS involves addressing the underlying cause, which is usually a chronic infection with a malaria parasite, particularly Plasmodium vivax or Plasmodium ovale.
**Why the Correct Answer is Right**
The treatment of choice for TSS is typically a combination of antimalarial drugs, specifically chloroquine and primaquine. Chloroquine works by inhibiting the parasite's ability to digest hemoglobin, thereby reducing the parasite load in the blood and liver. Primaquine, on the other hand, targets the liver stages of the parasite, preventing relapse of the disease. The combination of these two drugs is essential in treating TSS, as it addresses both the blood and liver stages of the parasite.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because corticosteroids, such as prednisolone, may be used to reduce inflammation and splenomegaly in TSS, but they do not address the underlying cause of the disease, which is the chronic malaria infection.
* **Option B:** This option is incorrect because splenectomy (removal of the spleen) is not a recommended treatment for TSS, as it does not address the underlying cause of the disease and may lead to increased susceptibility to infections.
* **Option C:** This option is incorrect because antiviral medications are not indicated in the treatment of TSS, as the disease is caused by a parasite, not a virus.
**Clinical Pearl / High-Yield Fact**
TSS is often associated with chronic malaria infection, and the use of chloroquine and primaquine is essential in treating the disease. It is also worth noting that TSS can be a complication of malaria in areas where the disease is endemic.
**Correct Answer:** C.