Foudroyanter Verlauf einer Malaria tropica

Abstract

Severe Plasmodium falciparum infection in non-immunized patients is a medical emergency and requires immediate diagnosis and treatment. Malaria should always be considered in the differential diagnosis in persons who have travelled to endemic areas and presenting not only with temperatures, but also with non-specific clinical signs, like cardiac arrhythmias. Although never entirely effective, chemoprophylaxis is highly recommended.

Heme attenuates beta-endorphin levels in leukocytes of HIV positive individuals with chronic widespread pain

“…Plasma levels of cell-free heme are elevated in several hemolytic and chronic inflammatory diseases, such as sickle cell disease [ 35 , 41 , 42 ], lupus arthritis [ 64 ], malaria [ 65 ], and following treatment with widely used platinum-based anticancer drugs [ 66 ]. However, the role of heme in HIV associated co-morbidities has not been yet elucidated.…”

Importierte Malaria tropica nach Keniaaufenthalt

“…Zwei Drittel der jährlich etwa 1000 gemeldeten Malariaerkrankungen in Deutschland werden durch Plasmodium falciparum, den Erreger der Malaria tropica, verursacht. Mehr als die Hälfte der betroffenen Patienten hatte keine wirksamen Prophylaxemaßnahmen (Chemoprophylaxe, Repellentien) durchgeführt (7,9,13). Angaben der WHO zufolge betrug die Mortalität der in Deutschland gemeldeten Malariaerkrankten in den Jahren 1989-1995 durchschnittlich 3,6% und lag damit deutlich über den Vergleichswerten aus Frankreich (2,0%) und Großbritannien (0,7%) (9).…”

“…Schwerwiegende Folgen von unterlassener Chemoprophylaxe und verspäteter Diagnose L. Schwake 1 , T. Junghanss 2 , J. Weimann 3 , W. Stremmel 1 1 Abteilung für Gastroenterologie, Infektionskrankheiten und Vergiftungen (Direktor: Prof. Dr. W. Stremmel) 2 Tropenmedizinische Ambulanz, Abteilung für Tropenhygiene und öffentliches Gesundheitswesen (Direktor: Prof. Dr. R. Sauerborn) und 3 Abteilung für Anästhesiologie (Direktor: Prof. Dr. E. Martin) des Universitätsklinikums Heidelberg Dtsch Med Wochenschr 0 0 1 2 -0 4 7 Imported Plasmodium falciparum malaria in a traveller to Kenya. Serious consequences of neglected chemoprophylaxis and delayed diagnosis History and admission findings: A 56-year-old man was admitted to the hospital 11 days after returning from Kenya because of recurrent fever attacks.…”

Commentary

“…[5] Positive anti-GAD levels are often implicated with strong antagonistic muscle contractions leading to rigidity in the lower limbs -a key feature in SPS. [4] Interestingly, our patient initially presented with spasmodic dysphonia-like symptoms, which made this case a diagnostic challenge. Also, our patient had a clinical picture similar to cranial nerve involvement, as seen by her ptosis of the eye (predominantly on the left side).…”

“…[1,3] Furthermore, other antibodies such as anti-amphiphysin and anti-gephryin may be elevated in SPS. [4] Decrease in Gamma Amino Butyric Acid (GABA), one of the main inhibitory neurotransmitters in the central nervous system (CNS) regulated by GAD, leads to a heightened stimulation of the muscles by motor neurons. [5] Positive anti-GAD levels are often implicated with strong antagonistic muscle contractions leading to rigidity in the lower limbs -a key feature in SPS.…”