Cerebral malaria in adults — a description of 526 cases admitted to Ispat General Hospital in Rourkela, India

Mishra, Saroj K.; Mohanty, Sanjib; Satpathy, Sudhir; Mohapatra, D. N.

doi:10.1179/136485907x157004

Cited by 48 publications

(45 citation statements)

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“…Most common presentation was jaundice which was present in 45.45% of cases. This is consistent with the finding of Mishra SK, et al 6 Severe jaundice in falciparum malaria results from hemolysis of both parasitized and non-parasitized red cells, hepatocyte injury and cholestasis6. Renal failure was present in 25.45% of patients (Table 4) which was comparable with studies conducted by Murthy GL, et al 7 The pathophysiology of renal failure in malaria has been described by Sitprija et al 8 It is thought that cytoadherence, multifactorial changes in cortical perfusion, cytokine release and hypovolemia lead to tubular necrosis.…”

Section: Discussionsupporting

confidence: 92%

Clinical profile and outcome of severe P. Falciparum malaria

et al. 2016

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INTRODUCTIONMalaria is a public health problem in more than 90 countries. According to the latest estimates of WHO, released in December 2015, there were 214 million cases of malaria in 2015 and 438 000 deaths.1 In India, during 2011, the malaria incidence was around 1.31 million cases, 0.67 million P. falciparum (Pf) cases and 754 deaths while during 2014 (till October), 0.85 million cases, 0.54 Pf cases and 316 deaths have been reported. 2Malaria is a public health problem in several parts of the country. About 95% population in the country resides in malaria endemic areas and 80% of malaria reported in the country is confined to areas consisting of 20% of population residing in tribal, hilly, difficult and inaccessible areas. Majority of studies of malaria are from endemic or hyper endemic areas of India. This study is of malaria in a tertiary care center in South Maharashtra, a hypo endemic area for falciparum malaria. The number of atypical presentations of malaria has gradually increased during the past few decades. Several factors have been attributed to increased morbidity and mortality in malaria with altered hematological and coagulation parameters, playing an important role. ABSTRACTBackground: Malaria is a public health problem in more than 90 countries. According to the latest estimates of WHO, released in December 2015, there were 214 million cases of malaria in 2015 and 438 000 deaths. The aim was to study clinical profile and outcome of severe falciparum malaria in patients at tertiary health care centre. Methods: In this prospective study, total 125 clinically diagnosed severe malaria cases admitted during period of November 2013 to October 2015, were enrolled excluding patients below 12 years of age. Detailed history and clinical examination was carried out to assess clinical severity and complications of malaria. Results: Of the 125 cases studied 110 cases were of severe malaria produced by Plasmodium falciparum infection diagnosed on peripheral smear examination or by antigen detection test. The remaining 15 cases were excluded from the study. In this study, seventy six (69.1%) cases were males and thirty four (30.9%) cases were females, with male: female ratio of 2.23:1. Common symptoms found were fever, chills and rigors, altered sensorium, jaundice and nausea or vomiting while most common complication was jaundice, seen in 45.45%. Mortality due to severe falciparum malaria observed was 13.63%. Conclusions: In this study of severe falciparum malaria, most common symptoms found were fever, chills and rigors, altered sensorium, jaundice, nausea and vomiting while most common signs were pallor, splenomegaly, icterus, hepatomegaly, bleeding tendencies and in a few cases neck stiffness and hypotension. Jaundice, renal failure, impaired consciousness and cerebral malaria were most common complications of severe falciparum malaria.

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Section: Discussionsupporting

confidence: 92%

Clinical profile and outcome of severe P. Falciparum malaria

et al. 2016

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“…The mortality rate varies from 15 -45% (6,(8)(9)(10). Mishra et al (11) reported in adult patients that mortality in malaria further increased if there was associated acute renal failure. Using RIFLE criteria to classify AKI in malaria in adults has been reported earlier (12).…”

mentioning

confidence: 99%

Acute Kidney Injury in Children withPlasmodium FalciparumMalaria: Determinants for Mortality

Prasad

Mishra

2015

Perit Dial Int

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“…Por esto, en todo paciente palúdico con ictericia debe descartarse la disfunción hepática o renal concomitante (36).…”

Section: Hiperparasitemiaunclassified

Signos de peligro en el paciente con malaria

Tobón

2009

biomedica

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Los signos de peligro son hallazgos clínicos que indican gravedad o que tienen utilidad para el pronóstico de complicación o muerte. En el paciente con malaria, o paludismo, se presentan signos clínicos o parasitológicos que pueden reconocerse fácilmente durante la fase aguda de la enfermedad y son indicadores del inicio de una complicación. Entre los signos de peligro que puede presentar el paciente con malaria se incluyen cambios neurológicos, alteraciones del patrón respiratorio, vómito y diarrea persistentes, ictericia, sangrados, orina oscura, llenado capilar lento, palidez intensa, hiperpirexia, hiperparasitemia y esquizontemia. Su reconocimiento oportuno contribuirá a la disminución de complicaciones y muertes.Palabras clave: malaria, paludismo, signos y síntomas, medicina clínica, examen físico, diagnóstico. Danger signs in the malaria patientDanger signs are clinical indicators of severity and are useful to predict complications or death. In the malaria patient, clinical or parasitological signs can be easily be recognized during the acute phase of the illness that indicate serious complications. Danger signs include neurological change, abnormal breathing pattern, persistent vomiting and diarrhea, jaundice, bleeding, dark urine, delayed capillary refill, intense pallor, hyperpyrexia, hyperparasitemia and schizontemia. Timely recognition of these signs can lead to a decrease in cases with complications and deaths. Los signos y síntomas generales de enfermedad se presentan en el paludismo, o malaria, no complicada con una frecuencia similar a como se presentan en la malaria complicada. Entre estos signos y síntomas están la fiebre, el escalofrío y la sudoración; otros hallazgos con frecuencia variable son la cefalea, el dolor osteo-muscular generalizado, la tos, el vómito y la diarrea (1). Sin embargo, otros signos que se presentan durante el curso de la enfermedad o que son sólo evidentes al momento del diagnóstico, se observan con mayor frecuencia en los casos complicados (1,2) y son indicio de deterioro clínico.Los signos de peligro son hallazgos clínicos o parasitológicos indicadores de gravedad o que tienen utilidad pronóstica de complicación o muerte. Los signos clínicos de peligro se establecen con el examen físico del paciente sin exámenes de laboratorio y pueden ser reconocidos por personal no médico. Los signos parasitológicos pueden ser detectados fácilmente por el microscopista en el examen de gota gruesa. Estos signos, llamados también signos de alerta, indican que el paciente evoluciona hacia enfermedad grave o que la complicación ya está presente, pero su presencia no constituye por sí sola un criterio de complicación (3-6). El tiempo que transcurre entre la aparición de estos signos y la complicación es incierto y, por ello, la presencia de cualquier signo de peligro indica la necesidad de atención médica inmediata y, en algunos casos, de hospitalización, mientras se aclara el estado clínico del paciente porque, además, la posibilidad de complicación está en Biomédica 2009;29:320-9

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Cerebral malaria in adults — a description of 526 cases admitted to Ispat General Hospital in Rourkela, India

Cited by 48 publications

References 12 publications

Clinical profile and outcome of severe P. Falciparum malaria

Clinical profile and outcome of severe P. Falciparum malaria

Acute Kidney Injury in Children withPlasmodium FalciparumMalaria: Determinants for Mortality

Signos de peligro en el paciente con malaria

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