1/29. Rare quadruple malaria infection in Irian Jaya indonesia.We report an exceptional finding from a blood slide collected in a remote area in the western half of new guinea Island (Irian Jaya Province, indonesia). One adolescent patient was found patently coinfected with all 4 known human malaria species, plasmodium falciparum, plasmodium vivax, plasmodium malariae, and plasmodium ovale. Diagnostic erythrocytic stages of all 4 species were clearly seen in the peripheral blood. A nested polymerase chain reaction, using species-specific primer pairs to detect dna, helped substantiate this finding. Previous reports from africa, thailand, and new guinea have detected all 4 species in a population but not simultaneously in an individual with a patent, microscopically detectable infection. We believe this quadruple infection represents the first reported natural case of all 4 human malaria parasites observed concurrently in the peripheral blood from a single Giemsa-stained slide.- - - - - - - - - - ranking = 1keywords = malaria, vivax (Clic here for more details about this article) |
2/29. Pseudo-reticulocytosis as a result of malaria parasites.Recently fully automated methods for enumerating reticulocytes have become available as an integral function in routine haematology analysers. In such methods, all intraerythrocytic nucleic acid is stained and can be regarded as representing reticulocytes. It has previously been shown that Howell-Jolly bodies may be counted as reticulocytes in automated flow cytometric methods. In the present paper, data from two patients are described indicating that severe malaria infection may lead to falsely increased reticulocyte counts, at least in the CELL-DYN(R) 4000 haematology analyser. In this instrument, the intraerythrocytic nuclear material of the parasites will be stained and counted as reticulocytes. This phenomenon appears to be independent of the type of Plasmodium infection. Clinical haematology laboratories should be aware of this potential source of pseudo-reticulocytosis.- - - - - - - - - - ranking = 0.68982003144359keywords = malaria (Clic here for more details about this article) |
3/29. Automated exchange transfusion for life-threatening plasmodium falciparum malaria--lessons relating to prophylaxis and treatment.We report a case of traveller to kenya who contracted severe plasmodium falciparum malaria complicated by disseminated intravascular coagulation and acute renal failure. She had taken no antimalarial prophylaxis in view of concerns in the media regarding the adverse effects of mefloquine. There was a protracted delay before the diagnosis of malaria was made. Clinical recovery occurred following treatment with intravenous quinine, haemofiltration and manual/automated red-cell exchange transfusions. Automated red-cell exchange transfusion resulted in a marked decrease in the parasitaemia, before a response to quinine therapy would have been anticipated, leading to a successful outcome thereafter. In conjunction with other groups we therefore feel that exchange transfusions should be considered in seriously ill patients with falciparum malaria, multiorgan complications and parasitaemias greater than 10%.- - - - - - - - - - ranking = 2.1035178127867keywords = plasmodium, malaria (Clic here for more details about this article) |
4/29. Automated erythrocytapheresis in the treatment of severe falciparum malaria.Removal of parasitized erythrocytes is generally considered to be of value as adjunctive therapy in severe falciparum malaria with high parasitaemia. This is commonly achieved by exchange transfusion. We describe three cases of severe falciparum malaria treated by automated erythrocytapheresis (red cell exchange) in addition to quinine and conventional supportive therapy. Erythrocytapheresis consists of removal of the red-cell fraction by apheresis. plasma, leukocyte and platelet fractions are returned to the patient. In all cases, dramatic reduction in parasitaemia was achieved within 2 h with subsequent complete clinical recovery. Erythrocytapheresis has significant advantages over exchange transfusion in terms of speed, efficiency, haemodynamic stability and retention of plasma components such as clotting factors and may thus represent an improvement in adjunctive therapy for severe malaria.- - - - - - - - - - ranking = 0.96574804402102keywords = malaria (Clic here for more details about this article) |
5/29. Automated RBC exchange transfusion:treatment for cerebral malaria.BACKGROUND: Cerebral malaria is a life-threatening complication of plasmodium falciparum infection. RBC exchange transfusion can reduce the level of parasitemia in this setting. Experience with automated RBC exchange for cerebral malaria may be limited, as most cases occur when the necessary equipment and blood components are not readily available. case reports: Three patients were admitted with cerebral malaria. parasites were found in more than 30 percent of RBCs in two cases and in more than 60 percent of RBCs in the third case. Many RBCs contained multiple organisms. In each case, antimalarial therapy was begun, and an automated RBC exchange was performed emergently with a cell separator. Exchange transfusion was repeated within 24 hours for two patients. parasitemia levels were less than 1 percent in all patients 24 hours after the last exchange. The neurologic status of these patients returned to baseline, and they were discharged 7 to 18 days after admission. CONCLUSION: Automated RBC exchange transfusion can rapidly reduce the level of parasitemia and restore neurologic functioning in patients with cerebral malaria.- - - - - - - - - - ranking = 1.2416760565985keywords = malaria (Clic here for more details about this article) |
6/29. Transfusion-associated falciparum malaria successfully treated with red blood cell exchange transfusion.Falciparum malaria is frequently associated with significant morbidity and mortality. The use of exchange transfusion as a therapeutic modality for severe cases of malaria has been described previously. We describe a case of a 49 year-old African American gentleman with a history of hemoglobin-SC disease who presented with a severe case of plasmodium falciparum malaria 3 weeks after having received an infected blood transfusion. His peripheral smear showed the presence of numerous intraerythrocytic ring forms and "banana-shaped" gametocytes with a high-grade parasitemia, estimated at 18%. He was treated with antimalarial chemotherapy and also underwent a 12-unit red blood cell exchange transfusion, decreasing his parasite load to < 1%, as determined on repeat smear. It is prudent to be aware of the efficacy of this adjunctive treatment, especially with ever-increasing travel and a resultant increase in the prevalence of tropical diseases in the united states.- - - - - - - - - - ranking = 1.1037120503097keywords = malaria (Clic here for more details about this article) |
7/29. 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.- - - - - - - - - - ranking = 0.82166767085551keywords = malaria, vivax malaria, vivax (Clic here for more details about this article) |
8/29. Red cell exchange, erythrocytapheresis, in the treatment of malaria with high parasitaemia in returning travellers.In severe falciparum malaria with high parasitaemia, removal of parasitized erythrocytes is generally considered to be of value as adjunctive therapy in addition to standard chemotherapy. Such removal is commonly achieved by exchange transfusion but this procedure is time-consuming and may be associated with haemodynamic disturbance. Current-generation automated cell-separator hardware and software allows prompt red cell exchange, erythrocytapheresis, in a single continuous-flow isovolaemic procedure. We describe the application of this procedure to 5 cases of severe falciparum malaria in travellers returning to the UK from the tropics. All patients also received quinine and conventional supportive therapy. In all cases, dramatic reduction in parasitaemia was achieved within 2 h with subsequent complete clinical recovery. Erythrocytapheresis has significant advantages over exchange transfusion in terms of speed, efficiency, haemodynamic stability and retention of plasma components such as clotting factors and may thus represent an improvement in adjunctive therapy for severe malaria.- - - - - - - - - - ranking = 0.96574804402102keywords = malaria (Clic here for more details about this article) |
9/29. Erythrocytapheresis for plasmodium falciparum infection complicated by cerebral malaria and hyperparasitemia.In malaria due to plasmodium falciparum, life-threatening complications are in part related to the degree of parasitemia. Whole blood exchange and red blood cell exchange (RCE) have been used for the rapid removal of parasites from the circulation of patients with a high parasite load complicated by cerebral, pulmonary, and renal dysfunction. We have treated three 5-45-year-old patients with hyperparasitemia and end-organ dysfunction with red cell exchange by automated apheresis as an adjunct to specific anti-malarial chemotherapy. parasitemia dropped more than 80% in all three patients immediately after the exchange, and all patients had an uneventful and full recovery. In combination with effective anti-malarial chemotherapy, apheresis RCE is a safe and rapid approach to treat complicated malaria due to P. falciparum.- - - - - - - - - - ranking = 1.1037120503097keywords = malaria (Clic here for more details about this article) |
10/29. Malarone treatment failure and in vitro confirmation of resistance of Plasmodium falciparum isolate from Lagos, nigeria.We report the first in vitro and genetic confirmation of Malarone (GlaxoSmithKline; atovaquone and proguanil hydrochloride) resistance in plasmodium falciparum acquired in africa. On presenting with malaria two weeks after returning from a 4-week visit to Lagos, nigeria without prophylaxis, a male patient was given a standard 3-day treatment course of Malarone. Twenty-eight days later the parasitaemia recrudesced. parasites were cultured from the blood and the isolate (NGATV01) was shown to be resistant to atovaquone and the antifolate pyrimethamine. The cytochrome b gene of isolate NGATV01 showed a single mutation, Tyr268Asn which has not been seen previously.- - - - - - - - - - ranking = 0.13796400628872keywords = malaria (Clic here for more details about this article) |
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