11/103. malaria diagnosis with the haematology analyser Cell-Dyn 3500: What does the instrument detect? The Cell-Dyn 3500 instrument could become a sensitive and specific tool in the diagnosis of malaria. The instrument appears to detect malaria-pigment within monocytes and granulocytes. A case of P. vivax malaria in a patient with increased osmotically resistant erythrocytes illustrates the potential of the instrument to detect intraerythrocytic parasites with pigment. However, in most malaria-patients with normal red cell osmotic resistance the observed phenomena seem rather to represent intraleukocytic pigment. This can remain in the circulation of clinically and parasitologically cured individuals and thus may not indicate acute infection. While the instrument can indicate those patients who have been infected a diagnosis of acute malaria must be established independently. ( info) |
12/103. Imported plasmodium vivax malaria in france: geographical origin and report of an atypical case acquired in Central or Western africa. A total of 73 cases of plasmodium vivax infections acquired in Western or Central africa were diagnosed on microscopical criteria in French travellers from 1995 to 1998. We report a case of P. vivax infection in a non immune traveller confirmed by polymerase chain reaction and presenting an atypical P. ovale morphology. The infection was acquired in Western or Central africa. These microscopical observations, together with the molecular evidence for P. vivax in Western and Central africa suggest that P. vivax is transmitted in this area despite lacking the Duffy receptor in autochthonous population. ( info) |
13/103. Probable locally acquired mosquito-transmitted malaria in georgia, 1999. In July 1999, the Centers for disease Control and Prevention received notification of a case of malaria in a 32-year-old female native of Colquitt County, georgia, who had no history of travel into an area where malaria transmission is endemic. An epidemiological investigation confirmed the absence of risk factors, such as blood transfusion, organ transplantation, malariotherapy, needle sharing, or past malaria infection. Active case finding revealed no other infected persons in Colquitt County. light trapping and larvae-dipping failed to identify adult or larval anophelines; however, Colquitt County is known to be inhabited by anopheles quadrimaculatus, a competent malaria vector. The patient's home was located near housing used by seasonal migrant workers from regions of southern mexico and central america where malaria is endemic, one of whom may have been the infection source. The occurrence of malaria in this patient with no risk factors, except for proximity to potentially gametocytemic hosts, suggests that this illness probably was acquired through the bite of an anopheles species mosquito. ( info) |
| malaria is one of the most common infectious diseases in the world, and severe respiratory complications have been described mainly in association with plasmodium falciparum. We describe a case of acute respiratory distress syndrome complicating infection with P. vivax in the setting of relatively low parasitemia in a 47-yr-old woman after a brief trip to papua new guinea. A review of the literature shows that pulmonary complications of P. vivax are rare but occur more frequently than generally acknowledged. Pathogenic mechanisms of these complications are discussed. ( info) |
| knowledge about the effects of cardiopulmonary bypass on malarial patients is scant. malaria-induced hemolysis can exercerbate by performing extracorporeal circulation on a patient infected with Plasmodium and may, therefore, lead to a critical hemolysis jeopardizing the clinical outcome. A 52-year-old patient suffering from malaria and endocarditis was scheduled for urgent aortic valve replacement. During extracorporeal circulation, free hemoglobin showed an increase to maximum of 392.5 mg/L (normal range < 50 mg/L), while haptoglobin decreased to the lowest value of 0.56 g/L (normal range 0.3-2.0 gL). Although hemolysis increased, pump run, weaning, and the postoperative course were uneventful. ( info) |
16/103. Transfusion-induced malaria in a child after open heart surgery in korea. We had an opportunity to evaluate a child who developed fever approximately two to three weeks after the open heart surgery for tetralogy of fallot. His peripheral blood smear showed rings and various stages of plasmodium vivax. The patient had received packed red blood cells during the surgery and postoperative care, one unit of which was later proved sero-positive for malaria. The possibility of malaria should be included in the differential diagnosis of the patients with unexplained fever after multiple blood product transfusions for the open heart surgery. ( info) |
17/103. malaria remains a military medical problem. OBJECTIVE: To bring military medical problems concerning malaria to the attention of the Defence Medical Services. METHOD: Seven military medical problems related to malaria are illustrated by cases referred for secondary assessment over the past five years. Each is discussed in relation to published data. RESULTS: The cases of failure of various kinds of chemoprophylaxis, diagnosis and treatment of malaria may represent just a fraction of the magnitude of the overall problem but in the absence of reliable published military medical statistics concerning malaria cases, the situation is unclear. CONCLUSION: Present experience suggests there are a number of persisting problems affecting the military population in relation to malaria. Only publication of reliable statistics will define their magnitude. Interim remedies are proposed whose cost-effectiveness remains to be established. ( info) |
18/103. Probable autochthonous plasmodium vivax malaria transmission in michigan: case report and epidemiological investigation. In September 1995, a michigan resident with no history of international travel was diagnosed with plasmodium vivax infection, and local mosquito-borne transmission was suspected. An epidemiological investigation did not identify additional cases of local transmission, and there was no apparent link to the 12 imported malaria cases detected in the region. Potential sites of nighttime outdoor exposure included a campground in a swampy area, close to a racetrack frequented by international travelers, some of whom were known to come from countries with malaria transmission. Entomological investigation identified anopheles spp. larvae and adults near the campsite. Summer temperatures 4.2 degrees C above average would have contributed to shortened maturation time of P. vivax within the insect vector, increasing the likelihood of infectivity. These investigations indicated that this patient probably acquired P. vivax infection through the bite of a locally infected anopheles spp. mosquito. physicians need to consider malaria as a possible cause of unexplained febrile illness, even in the absence of international travel, particularly during the summer months. ( info) |
| malaria transmission in the united states was largely eliminated during the mid-20th century; however, sporadic cases of locally acquired mosquito-transmitted malaria continue to occur. Since 1997, four separate probable mosquito-transmitted malaria outbreaks have been reported to CDC, including one from virginia. This report describes the investigation of two cases of plasmodium vivax malaria that occurred in northern virginia in August 2002, and underscores the need for clinicians to consider the possibility of malaria in patients with fever of unknown origin. ( info) |
20/103. Cerebral involvement in benign tertian malaria. Although plasmodium vivax usually causes benign uncomplicated malaria, it can occasionally result in severe disease with life-threatening, end-organ involvement generally seen with falciparum malaria. We report a case of cerebral malaria caused by P. vivax and review the literature on this subject. ( info) |