Splenomegaly

- returning traveler who is febrile with palpable spleen: Malaria until proven otherwise (LR 6.6)
- Palpable spleen strongly argues for splenomegaly (LR 8.5)
- If liver is also enlarged, it argue for hepatic disease (LR 2.7)
- splenic percussion signs are less convincing than palpation 

(Katharine Cheung MD, 3/10/11)