Symmetric peripheral gangrene with mixed malaria

Agrawal, Avyact; Rastogi, Ashu; Tiwari, Dr Varsha

doi:10.1007/s12098-007-0100-4

Cited by 12 publications

(7 citation statements)

References 6 publications

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“…Viral gastroenteritis has also been described as a causative factor of SPG. [15] Noninfective causes of SPG include myocardial infarction, [15] cardiac failure, [1,15] hypovolemic shock, [1] hypertension, [1] pulmonary embolism, [15] supraventricular tachycardia, Hodgkin's lymphoma, [12] systemic lupus erythematosus, [20] polymyalgia rheumatica, [12] decreased levels of protein C and protein S, [21] antiphospholipid antibodies, [14] cryoglobulinemia, acute lymphatic leukemia, [16] dog bite, [3] appendicitis, [15] extra corporeal shock wave lithotripsy, [22] suprapubic prostatectomy, [23] cholecystectomy, [6] sickle cell disease, [20] hyper osmolar coma, [15] hypernatremic dehydration, small cell lung cancer. [24] Drugs [15] like adrenaline, noradrenaline, [25] and dopamine [26] may also be important causative factors.…”

Section: Plasmodiummentioning

confidence: 99%

Symmetrical peripheral gangrene

Ghosh¹,

Bandyopadhyay²

2011

Indian J Dermatol Venereol Leprol

115

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Section: Plasmodiummentioning

confidence: 99%

Symmetrical peripheral gangrene

Ghosh¹,

Bandyopadhyay²

2011

Indian J Dermatol Venereol Leprol

115

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“…It has mostly been described with P. falciparum or mixed vivax and falciparum malaria. [1][2][3][4][5] It is usually also seen in the presence of DIC. [2][3][4] It is hypothesised that heavy parasitaemia causes various antigenically diverse parasite-derived molecules, expressed on the erythrocyte membrane, to interact with several endothelial cell surface receptors such as CD36, ICAM 1, thrombospondin, VCAM and E-Selectin, causing stickiness of red blood cells (RBCs).…”

Section: Discussionmentioning

confidence: 99%

“…Only two case reports were found where gangrene was described in the absence of DIC and was attributed to a combination of parasite and host factors such as anaemia, hypoxia and shock. 1,5 A few postulated mechanisms for thrombocytopenia in malaria include macrophage activation, increased levels of cytokines and anti-platelet immunoglobulin which cause platelet destruction. Specific immunoglobulins have been implicated in binding with malarial antigen on platelets and causing platelet destruction.…”

Section: Discussionmentioning

confidence: 99%

Peripheral gangrene in an 18-month-old boy withPlasmodium vivaxmalaria

Raghunandan¹,

Rajeshwari²,

Dubey³

et al. 2012

Paediatrics and International Child Health

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An 18-month-old boy presented with a high-grade fever, generalised petechiae and rapidly progressive, blackish discolouration of the fingers of the hands for the past 3 days. At presentation, he was haemodynamically stable. There were gangrenous changes in the index and middle fingers of both hands. Plasmodium vivax was demonstrated in the peripheral blood smear but there was no evidence of disseminated intravascular coagulopathy. The platelet count fell to 10×10(9)/L. Bone marrow aspiration to rule out leukaemia demonstrated schizonts of P. vivax with some atypical lymphocytes. The fingers recovered completely. As far as we are aware, this is the first report of peripheral gangrene associated with P. vivax malaria.

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“…Symmetrical peripheral gangrene (SPG) is characterized by distal ischemic damage in two or more extremities, without large vessel obstruction. This syndrome has been reported in several conditions such as infections, disseminated intravascular coagulation (DIC), and low cardiac output states; it is rarely associated with P. falciparum and mixed malarial infections [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Disseminated intravascular coagulation presenting as symmetrical peripheral gangrene: a case report

et al. 2019

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Introduction Plasmodium vivax was traditionally thought to be benign; however, nowadays it presents with a myriad of systemic complications like cerebral malaria, acute respiratory distress syndrome, acute kidney injury, acute pancreatitis, hepatic dysfunction, and disseminated intravascular coagulation, which were earlier attributed only to Plasmodium falciparum malaria. Here we report a case of a middle-aged man who presented with disseminated intravascular coagulation manifesting as symmetrical peripheral gangrene. What makes this case more interesting is that the malaria isolated was Plasmodium vivax instead of Plasmodium falciparum . Such findings were previously reported, but this is the first case where the patient was managed conservatively with antimalarial drugs without the need for amputation, which focuses on the very important role of early diagnosis and timely management. Case presentation A 44-year-old Indian man from north India presented with history of fever of 2 days’ duration with severely painful cold extremities. No pulse could be recorded on examination. A diagnosis of symmetrical peripheral gangrene was made. During the etiological evaluation, Plasmodium vivax malaria was found leading to disseminated intravascular coagulation causing this complication. He was started on artesunate and lumefantrine combination therapy and he recovered completely without the requirement of amputation. Conclusion This case highlights the non-benign nature of Plasmodium vivax and its emerging complications. Also it correlates symmetrical peripheral gangrene with Plasmodium vivax malaria. It also emphasizes the importance of timely diagnosis and intervention to reduce mortality and morbidity.

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Symmetric peripheral gangrene with mixed malaria

Cited by 12 publications

References 6 publications

Symmetrical peripheral gangrene

Symmetrical peripheral gangrene

Peripheral gangrene in an 18-month-old boy withPlasmodium vivaxmalaria

Disseminated intravascular coagulation presenting as symmetrical peripheral gangrene: a case report

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