Malarial Related Myopathies: A Rhabdomyolysis Story

Abstract

Malaria is amongst the most prevalent and epidemiologically relevant global parasitic protozoan infections. It is infecting millions of people annually, especially in south east Asia and sub Saharan Africa. Its morbidity and mortality still cannot be controlled entirely and elimination is still far away. Children and pregnant women are among the most vulnerable group in the population. Its pathobiology have related to cause direct or indirect deleterious effect on the patient’s skeletal muscle, named rhabdomyolysis. Eventhough it is very rare, but potentially fatal and lethal. Three mechanism of malaria related rhabdomyolysis are very intense inflammatory response, extensive red cells sequestration in muscle capillaries due to severe anemia and the parasite toxin’s, will lead to or add risks of complication. Derangement of specific type of muscle, named the skeletal and cardiac, is amongst the earliest sign of severe malaria. Further study need to be conducted in the future, especially on important topics about mechanism and its effect, signaling pathways, best practice on laboratory approach and management strategy best practice.

Characteristics of pediatric rhabdomyolysis and the associated risk factors for acute kidney injury: a retrospective multicenter study in Korea

“…Fluid resuscitation has been widely used to treat rhabdomyolysis, and it was also the most commonly used method in our study. Although fluid therapy is emphasized by consensus [5,37,38], other treatment methods are still controversial. Dawley [37] reported that management consists of rapidly aggressive intravenous resuscitation to maintain urine output and limited use of bicarbonate for acidosis and mannitol for oliguria, respectively.…”

“…Although fluid therapy is emphasized by consensus [5,37,38], other treatment methods are still controversial. Dawley [37] reported that management consists of rapidly aggressive intravenous resuscitation to maintain urine output and limited use of bicarbonate for acidosis and mannitol for oliguria, respectively. Michelsen et al [38] reported guidelines that recommend early fluid resuscitation using crystalloids but not the routine use of diuretics, mannitol, alkalization, or RRT.…”

Epidemiology of Pathogenic Free-living Amoeba

“…Unlike approaches to more common parasitic agents, e.g., malaria with no matter how obscure the clinical manifestations, cases of FLA are often missed because they are rarely recognized. [21] FLA is also not part of normal flora or common human microbiome, so their existence in the human body, especially in deep organ is often hidden and hard to detect [22]. A fast and efficient diagnosis is mandatory, however it depends on two variables: (1) the familiarity of practitioner with the symptomatology and treatment of FLA infections, and also (2) the sufficiency and appropriate clinical material (qualitatively and quantitatively) in order to be processed for making a fast and definitive diagnosis [23].…”