Clinical Features of Plasmodium Vivax Malaria

Song, Hun Ho; O, Soon Ok; Kim, Su Ho; Moon, Sang Ho; Kim, Jin Bong; Yoon, Jong Il; Koo, Ja Ryong; Hong, Kyung-Soon; Lee, Myung Goo; Kim, Dong Joon; Shin, Dong Hoon; Kang, Sung Ha; Choi, Moon Gi; Lee, Kwang Hack

doi:10.3904/kjim.2003.18.4.220

Cited by 31 publications

(29 citation statements)

References 6 publications

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“…In contrast, in temperate areas, relapses are fewer and delayed, and the haematological impact of each recurrence is less (Song et al . ; Goller et al . ; Price et al .…”

Section: Pathogenesis Of Disease In Vivax Malariamentioning

confidence: 99%

Severe Malaria

2014

Tropical Med Int Health

459

354

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Fever and diarrhea developed in a 34-year-old Swiss man two weeks after his return from Madagascar. Before his visit he had not taken any prophylactic antimalarial drugs. Despite self-treatment with ciprofloxacin and metronidazole, he remained febrile. He also reported hematuria and dark urine. On admission, his temperature was 39.2°C and his vital signs and mental status were normal. The abdomen was tender, and the spleen was palpable 15 cm below the costal margin. The hemoglobin level was 12.4 g per deciliter, the hematocrit was 35 percent, the white-cell count was 8500 per cubic millimeter, and the platelet count was 15,000 per cubic millimeter. The creatinine level was 2.6 mg per deciliter (234 µmol per liter), the lactate dehydrogenase level was 1920 U per liter (normal, 187 to 443), and the bilirubin level was 11.5 mg per deciliter (197 µmol per liter); the results of other liver-function tests were in the normal range. Examination of blood smears showed severe infestation with Plasmodium falciparum, with 70 to 80 percent of red cells containing up to five parasites (small ring forms) per cell (long arrow in Panel A). Other features of P. falciparum that were present included chromatin dots (arrowheads in Panel A) and appliqué forms (short arrow in Panels A and B; Wright's stain, ¬1000). About 70 percent of the neutrophils contained hemozoin (shown in a band form [long arrows] in Panel B). The patient was treated with intravenous quinine sulfate and exchange transfusions, with dramatic improvement. The degree of parasitemia fell to 65 percent after the first exchange transfusion and to 8 percent after the second. The patient's course was complicated by acute renal failure, the acute respiratory distress syndrome, and spontaneous rupture of the spleen, necessitating continuous hemofiltration, mechanical ventilation, and laparotomy with splenectomy. Despite these complications , the patient was able to return home within three months and was well at the last follow-up visit.

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“…In contrast, in temperate areas, relapses are fewer and delayed, and the haematological impact of each recurrence is less (Song et al . ; Goller et al . ; Price et al .…”

Section: Pathogenesis Of Disease In Vivax Malariamentioning

confidence: 99%

Severe Malaria

2014

Tropical Med Int Health

459

354

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“…Although a few studies targeting civilians in the Republic of Korea have been conducted since the re-emergence of malaria, most of the studies analyzed a small group of patients [7, 8]. This study is aimed at analyzing clinical features of vivax malaria and characteristics of recurred malarial patients who were treated at a hospital located in the northwestern part of Gyeonggi province where malaria is prevalent.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Vivax Malaria and Analysis of Recurred Patients

et al. 2013

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BackgroundPlasmodium vivax malaria is an acute debilitating illness characterized by recurrent paroxysmal fever and relapses from hypnozoites in the liver. Although a few studies reported clinical characteristics of vivax malaria in civilians after reemergence in the Republic of Korea, only a small group of patients was analyzed.Materials and MethodsWe retrospectively reviewed the medical records of patients who had been diagnosed with vivax malaria by peripheral blood smear in a university-affiliated hospital located in a malaria-endemic area between January 2005 and December 2009.ResultsDuring the study period, a total of 352 malarial cases from 341 patients were diagnosed. Vivax malaria was most commonly developed in July and August, 24.7% (87/352), and 21.9% (77/352), respectively. The mean (SD) age was 42.5 (14.7) years and the number of male patients was 243 (71.3%). Six patients had a previous history of vivax malaria from 6 months to 10 years before. A total of 337 patients (98.8%) had fever and the mean (SD) body temperature was 38.3 (1.4)℃. Common associated symptoms were chills (213/341, 62.5%), headache (115/341, 33.7%), and myalgia (85/341, 24.9%). Laboratory findings included thrombocytopenia (340/341, 99.7%), anemia (97/341, 28.5%), leukopenia (148/341, 43.4%), increase of aspartate transaminase (177/341, 51.9%), and increase of alanine transaminase (187/341, 54.8%). Hypotension (14/341, 4.1%), altered mentality (3/341, 0.9%), azotemia (3/341, 0.9%), spleen infarction (2/341, 0.6%), and spleen rupture (1/341, 0.3%) developed as complications. Chloroquine was administered to all patients and primaquine was administered with mean (SD) 3.39 (0.82) mg/kg to 320 patients. There were 11 recurrent infections during the study period. The median (range) time to recurrent infection was 100 (32-285) days. Platelet counts were higher (86,550 vs. 56,910/mm3) and time to treatment of malaria was shorter (5 vs. 7 days) in relapsed cases compared with first occurrence cases (P=0.046).ConclusionsThe overall recurrence rate of vivax malaria was 3.2% (11/341) in this study. In recurred cases, malaria was diagnosed earlier and thrombocytopenia was less severe. To evaluate the risk factors associated with recurrence and adequate dose of primaquine in Korean patients, further large-scale prospective studies will be needed.

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“…Thrombocytopenia was a prominent finding in 75% of the cases at diagnosis, which resolved during therpy. 13 Memon et al when studying thrombocytopenia in hospitalised patients found (70%) patients had thrombocytopenia. 93% patients with thrombocytopenia were P. falciparum positive and only 7% patients had vivax malaria.…”

Section: Discussionmentioning

confidence: 99%