Autopsy discoveries of death from malaria

ÖZSıtma genellikle antemortem, az sayıda vakada postmortem tanısı koyulabilen ölümcül bir protozoon enfeksiyonudur. Elli beş yaşında Türk vatandaşı olan erkek, Ekvator Ginesi'nden otopsi için gönderilmiştir. Bir ay önce yurt dışına çalışmak için gittiği ancak sıtma için proflaksisini yarım bıraktığı, orada bulunan bir hastanenin acil servisine bilinci kapalı halde götürüldüğü öğrenilmiştir. Serebral sıtma ön tanısıyla kinin ve klindamisin tedavisine başlanan vakanın 3. günün sonunda durumunun kötüleşmesi üzerine ex olduğu bildirilmiştir. Postmortem dokuların histopatolojik incelemesinde; beyin, beyincik ve beyin sapında; dağınık odaklar halinde küçük çaplı kanamalar, ortasında nekrotik vaskü-ler yapılar, damar yapıları çevresinde açık kahverenkli pigment yüklü hücreler görüldüğü, dalak ve kemik iliğinde; pigment yüklü hücreler görüldüğü bildirilmiştir. Serebral malarya; Plasmodium enfeksiyonlarının nadir görülen hızlı seyirli ölümcül komplikasyonlarından biridir. Ülkemizde yerli sıtma olguları azalmasına rağmen, yurt dışına endemik bölgelere seyahat eden kişilerde sıtma enfeksiyonun görülebileceği unutulmamalı, bu bölgelere seyahat edeceklere uygun sıtma profilaksisi önerilmelidir. (Turkiye Parazitol Derg 2015; 39: 234-7) Anahtar Kelimeler: Serebral sıtma, postmortem, proflaksi Geliş Tarihi: 09.06.2014Kabul Tarihi: 27.02.2015 ABSTRACTMalaria is a lethal protozoan infection which is generally diagnosed antemortem and rarely diagnosed postmortem in a few cases. A fifty five year old, Turkish citizen male has been referred for autopsy. It has been found that he has gone abroad to work a month ago, however, quitted malaria prophylaxis before the intended end and brought into the emergecy department in an unconscious state.Following quinine and clindamycin treatment with the initial diagnosis of cerebral malaria, the case was reported to have died due to his general condition got worsened at the end of the third day of therapy.Histopathological evaluation of postmortem tissues was revealed haphazardly arranged minor bleedings and central vascular necrotic foci in the cerebrum, cerebelum and brain stem; light brown pigment containing cells around vasculature; and pigment containing cells in the spleen and bone marrow. Cerebral malaria has a rapid course and is rare but one of the lethal complications of infections with Plasmodium. Although domestic malaria cases has been decreasing in our country, it should be kept in mind that the malaria infection can be seen in persons travelling abroad to high endemic malarial regions and an appropriate antimalarial prophylaxis should be recommended to those overseas travellers. (Turkiye Parazitol Derg 2015; 39: 234-7)

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“…Bu nedenle malarya enfeksiyonu endemik bölgelere seyahat hikayesi olan, beklenmeyen ani ölüm vakalarında mutlaka akla getirilmelidir (22).…”

Section: Olgu Sunumuunclassified

An Autopsy Case of Sudden Death Caused by Cerebral Malaria Infection

Yağmur

As²,

Karayel³

et al. 2015

TurkiyeParazitolDerg

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“…The presence of parasite forms in the Giemsa staining of these preparations establishes the diagnosis [5]. In addition to the blood sampling in postmortem cases, the preparations made with hematoxylin eosin from the histopathological tissue sampling may allow visualization of trophozoite, schizont, or pigment structures of the malaria parasite [6,12,13]. However, the pigment structures were seen rather than the trophozoite forms of the parasite due to the extended postmortem interval or the antimalarial treatment [13].…”

Section: Discussionmentioning

confidence: 99%

“…The ineffectiveness of taking the malaria prophylaxis and visiting endemic regions without education result in the occurrence of foreign-based malaria cases [5]. Therefore, malaria must be considered in the cases with unexpected sudden deaths and a history of travel [6].…”

mentioning

confidence: 99%

Two cases of malaria due to Plasmodium falciparum resulting in death: postmortem identification

Yağmur¹,

Kara²,

Gürler³

et al. 2015

RJLM

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Plasmodium falciparum, a malaria agent, is an important cause of morbidity and mortality in people who travel to the regions where this parasite is endemic. A 53-year old Turkish man was sent for an autopsy after death due to malaria complications from Mozambique. A 65-year-old German man was intubated at the airport due to the impaired overall status and admitted to the intensive care unit. The patient could not be diagnosed and died. The next day, an autopsy was performed on the patient. Malaria pigment was seen within the blood cells at the Giemsa staining of blood in both cases. Plasmodium falciparum DNA was positive in the analysis performed with blood samples from the patients. Postmortem sampling and demonstration of plasmodium DNA is among the important methods for diagnosis in cases with sudden death and a history of travel to foreign countries, where the antemortem diagnosis cannot be made.

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“…In fact, Pk as a cause of other morbid conditions (Gram-negative sepsis) has been reported. Pathologically, where Pf shows intense sequestration in the brain along with congestion and possibly brain swelling, Pk has a similar appearance in tissue with a curious lack of ICAM-1 in the brain (Cox-Singh et al 2010;Menezes et al 2012). The Pk family of genes homologous to Pf var genes is the SICAvars, which are larger in structure (12 vs. two exons) and quantity (.200 vs. 60) than the var genes of Pf (Lapp et al 2009).…”

Section: P Knowlesimentioning

confidence: 99%

Malaria Pathogenesis

Milner¹

2017

Cold Spring Harb Perspect Med

203

121

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In the mosquito-human life cycle, the six species of malaria parasites infecting humans (, ,, ,, and ) undergo 10 or more morphological states, replicate from single to 10,000+ cells, and vary in total population from one to many more than 10 organisms. In the human host, only a small number of these morphological stages lead to clinical disease and the vast majority of all malaria-infected patients in the world produce few (if any) symptoms in the human. Human clinical disease (e.g., fever, anemia, coma) is the result of the parasite preprogrammed biology in concert with the human pathophysiological response. Caveats and corollaries that add variation to this host-parasite interaction include parasite genetic diversity of key proteins, coinfections, comorbidities, delays in treatment, human polymorphisms, and environmental determinants.

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Autopsy discoveries of death from malaria

Cited by 9 publications

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An Autopsy Case of Sudden Death Caused by Cerebral Malaria Infection

An Autopsy Case of Sudden Death Caused by Cerebral Malaria Infection

Two cases of malaria due to Plasmodium falciparum resulting in death: postmortem identification

Malaria Pathogenesis

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