Severe thrombocytopenia with bleeding manifestations in two children secondary to Plasmodium vivax

Bhatia, Vidyut; Bhatia, Jyoti

doi:10.3109/09537100903518278

Cited by 13 publications

(14 citation statements)

References 11 publications

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“…Bleeding manifestations in severe malaria cases are due to hyperactive platelets which will enhance homeostatic responses. 15 Altered sensorium, impaired consciousness (with Glassgow coma scale <9) were also found in the study and presented as cerebral malaria. Most of the studies report cerebral malaria as a lethal entity and children as most susceptible groups.…”

Section: Discussionsupporting

confidence: 53%

Clinico-epidemiological features of malaria among children attending a tertiary care hospital: a two year study

Munagala

UmaMahesh

Kandati

et al. 2017

Int J Contemp Pediatr

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Background: Malaria caused by Plasmodium species and transmitted by Female anopheles mosquito, still remains as a major public health concern around the world. India is one of the major contributors of malaria cases in South East Asia. Malaria accounts for 205,000 deaths with 55,000 deaths occurring in early childhood. In endemic areas, children under 5 years are particularly susceptible to infection, illness and death. The present study was aimed to study the clinical, epidemiological profile of malaria cases among children (<12 years) attending a tertiary care hospital. We also assessed the complications associated with non-severe and severe malaria. Methods: The study was conducted at a tertiary care hospital for a period of two years and all children <12 years of age diagnosed with malaria were enrolled in the study. The demographic, clinical and laboratory parameters were observed and noted. Cases were categorized into severe and non-severe malaria based on the WHO guidelines.Results: A total of 2420 cases were observed and 250 cases of malaria were diagnosed, of which 136 were p. vivax mono infections, 82 falciparum malaria and 32 had evidence of mixed infections. Males were predominant in the study (58.8%) and 1-5 years was the common age group. Fever was the most common symptom (100%) in all cases and pallor, edema was common in falciparum malaria. jaundice was observed in 62% of mixed infections and altered sensorium in 43% of mixed infections. Severe malaria was observed almost equally in vivax and falciparum cases. Hyperparasitemia, cerebral malaria was common in falciparum cases than vivax. Thrombocytopenia, hypoglycemia and impaired consciousness were more common in mixed infections than falciparum and vivax cases.Conclusions: Present study finally concludes that there is a significant change in the trends of vivax malaria in this region where both species coexist. The spectrum of complications seen in vivax and falciparum follow a similar pattern, then mentioned earlier that complications are less frequently seen in vivax than falciparum malaria. Hence more number of studies is required to generate the differing patterns associated with vivax and compare them with different studies from geographic regions.

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Section: Discussionsupporting

confidence: 53%

Clinico-epidemiological features of malaria among children attending a tertiary care hospital: a two year study

Munagala

UmaMahesh

Kandati

et al. 2017

Int J Contemp Pediatr

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“…[7][8][9]13,[24][25][26][27][28][29][30][31][32][33][34] Furthermore, our study in a vivax monoendemic setting adds to the only two case series that strictly ruled out P. falciparum coinfection by highly specific techniques (i.e., PCR) and shows that P. vivax alone may, indeed, present with severe manifestations. 13,14 In agreement with these two studies conducted in Brazil and India, respectively, we found that there were four criteria (severe anemia, shock, lung injury, and acute renal failure) ( Table 4) that are commonly present in critical illness with P. vivax, despite our use of few criteria to identify critically ill severe vivax cases.…”

Section: Case Control Analysismentioning

confidence: 87%

Plasmodium vivax Hospitalizations in a Monoendemic Malaria Region: Severe Vivax Malaria?

Quispe

Pozo

Guerrero

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Severe malaria caused by Plasmodium vivax is no longer considered rare. To describe its clinical features, we performed a retrospective case control study in the subregion of Luciano Castillo Colonna, Piura, Peru, an area with nearly exclusive vivax malaria transmission. Severe cases and the subset of critically ill cases were compared with a random set of uncomplicated malaria cases (1:4). Between 2008 and 2009, 6,502 malaria cases were reported, including 106 hospitalized cases, 81 of which fit the World Health Organization definition for severe malaria. Of these 81 individuals, 28 individuals were critically ill (0.4%, 95% confidence interval = 0.2-0.6%) with severe anemia (57%), shock (25%), lung injury (21%), acute renal failure (14%), or cerebral malaria (11%). Two potentially malaria-related deaths occurred. Compared with uncomplicated cases, individuals critically ill were older (38 versus 26 years old, P < 0.001), but similar in other regards. Severe vivax malaria monoinfection with critical illness is more common than previously thought.

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“…A second possible explanation for the haemothorax described here is that (independently of the splenic complications) a spontaneous haemorrhage happened in the patient's supradiaphragmatic space. Human infection with P. vivax can induce anaemia and thrombocytopeniavia haemolysis, reduced cell deformity of (parasitised and nonparasitised) erythrocytes, increased splenic clearance, reduction of platelet survival, decreased platelet production, and increased splenic uptake of platelets -that are severe enough to provoke spontaneous bleeding and other haemostatic abnormalities (Gorski et al, 1993;Thapa et al, 2009;Bhatia and Bhatia, 2010).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous haemothorax and haemoperitoneum inPlasmodium vivaxmalaria

Hong

et al. 2011

Annals of Tropical Medicine & Parasitology

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Severe thrombocytopenia with bleeding manifestations in two children secondary to Plasmodium vivax

Cited by 13 publications

References 11 publications

Clinico-epidemiological features of malaria among children attending a tertiary care hospital: a two year study

Clinico-epidemiological features of malaria among children attending a tertiary care hospital: a two year study

Plasmodium vivax Hospitalizations in a Monoendemic Malaria Region: Severe Vivax Malaria?

Spontaneous haemothorax and haemoperitoneum inPlasmodium vivaxmalaria

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