1/18. Management of severe and complicated malaria in the intensive care unit.malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14th week of pregnancy, admitted to the ICU in a coma, with pulmonary oedema, haemolytic anaemia, renal failure and thrombocytopenia as complications of P. falciparum malaria. The case is discussed and possible explanations for the clinical picture and complications of P. falciparum malaria are given in the light of experiences from the literature.- - - - - - - - - - ranking = 1keywords = malaria (Clic here for more details about this article) |
2/18. Congenital malaria: a case report.Congenital malaria is an uncommon disease even in endemic areas. A 19-day-old female infant with congenital malaria is presented. The mother of the patient was diagnosed to have malaria at the seventh month of gestation and was treated with chloroquine orally for three days. No malarial prophylaxis was given. The infant developed fever, hyperbilirubinemia, anemia and hepatosplenomegaly postnatally. Thin blood smears revealed many plasmodium vivax parasites. She was treated with oral chloroquine for three days. We emphasize the importance of adequate antenatal medical therapy and prophylaxis during pregnancy.- - - - - - - - - - ranking = 1.2058727561998keywords = malaria, vivax (Clic here for more details about this article) |
3/18. The potential utility of the Semi-Nested Multiplex PCR technique for the diagnosis and investigation of congenital malaria.We report three cases of congenital malaria involving two malarial immune mothers living in spain. Diagnostic PCR and Genotyping PCR for merozoite surface proteins 1 and 2 were essential to show that mothers and new-borns had different Plasmodium population parasites at the moment of the delivery, and that the infection was acquired earlier in gestation by transplacental transmission. In the first case the Plasmodium species founded in both, mother and child were different. malaria in the twins showed a mixed infection (P. falciparum plus P. malariae) while the mother presented a P. falciparum infection. These facts were confirmed studying the polymorphisms for MSP1 and MSP2. Blood samples of the newborns were analyzed an half hour after delivery excluding the possibility of re-infection by mosquito bite and indicating a vertical transmission during pregnancy.- - - - - - - - - - ranking = 1keywords = malaria (Clic here for more details about this article) |
4/18. Persistence of plasmodium falciparum in the placenta after apparently effective quinidine/clindamycin therapy.The persistence of plasmodium falciparum in the placenta after apparently adequate therapy with quinine has been described. We describe this phenomenon in the placenta of a 19-year-old woman with falciparum malaria, who was treated with a combination of quinidine and clindamycin. Although this therapy was effective and diminished her peripheral blood parasitemia from 3% at presentation to almost undetectable at the time of delivery, vast numbers of P. falciparum-infected erythrocytes were present in the maternal sinusoids of the placenta. This sequestration of infected erythrocytes produced a local parasitemia in the placenta of 70% to 80%. Additionally, rare Plasmodium-infected erythrocytes were also seen in the fetal blood of the placenta. We review malaria in pregnancy, parasitic involvement of the placenta and emphasize that Plasmodium-infected erythrocytes may persist in the placenta even after clearance of parasites from the peripheral blood.- - - - - - - - - - ranking = 0.28571428571429keywords = malaria (Clic here for more details about this article) |
5/18. pregnancy complicated by malaria, precipitate labor and uterine rupture.A case of plasmodium falciparum malaria is reported in a 25-year-old pregnant woman with a history of three previous cesarean sections. She developed premature precipitate labor which was complicated by stillbirth, uterine rupture, bladder and vaginal tears necessitating hysterectomy.- - - - - - - - - - ranking = 0.71428571428571keywords = malaria (Clic here for more details about this article) |
6/18. Imported malaria in the Bronx: review of 51 cases recorded from 1986 to 1991.The cases of 51 patients with malaria seen at the Albert Einstein College of medicine hospitals from January 1986 to June 1991 are reviewed. Thirty-five patients acquired infection on journeys to their country of origin. Of these 35 patients, 83% of whom had lived in the united states for > or = 2 years, only 17% received antimalarial prophylaxis. Ten of the 51 patients were born and raised in the united states, and 70% received prophylaxis (P < .01). Six of the 51 patients were visitors to the united states from areas endemic for malaria. overall, 64% of patients acquired malaria in West africa, south of the Sahara; 20% in asia; 8% in ecuador; 6% in haiti; and 4% in the middle east. The majority of infections were due to plasmodium falciparum. Six patients traveled to a zone endemic for malaria while pregnant, and none received prophylaxis. In nine of 13 patients who received prophylaxis, there was inadequate dosing or poor compliance. Individuals born in regions endemic for malaria are at high risk of acquiring malaria on return to their countries of origin and are less aware of the need for malaria prophylaxis than are other travelers.- - - - - - - - - - ranking = 1.7142857142857keywords = malaria (Clic here for more details about this article) |
7/18. Imported malaria in the 1990s. A report of 59 cases from Houston, Tex.OBJECTIVE: To determine the frequency, the clinical features, and the response to therapy of imported malaria that was diagnosed in the 1990s in a major North American city. METHOD: A retrospective case series from Houston, Tex, of 59 cases of imported malaria presenting between January 1990 and April 1993. RESULTS: malaria was diagnosed in 59 patients, consisting of 12 cases among patients who had acquired the infection while they were living in endemic areas prior to immigration to the united states, 32 cases among US residents who were originally from endemic areas, and 15 cases among patients originally from north america or europe. Only 12 patients had received malarial prophylaxis: eight with chloroquine, one with chloroquine and chloroguanide (proguanil), two with chloroquine and primaquine, and one with mefloquine taken intermittently. Eight presented with plasmodium falciparum infection after receiving chloroquine, and one, after receiving chloroquine and chloroguanide. Two presented with malaria caused by plasmodium vivax despite receiving chloroquine and primaquine as prophylaxis. In 25 cases, malaria was not considered as an initial diagnosis. Five patients presented with severe disease (three with severe hemolysis, two each with cerebral malaria and renal failure, and one with adult respiratory distress syndrome). Four of the five had initially received a misdiagnosis. Two patients died despite treatment with intravenous quinidine and exchange transfusions. Two patients with P vivax infection had multiple relapses despite courses of chloroquine and primaquine. Six patients were pregnant (including one with a fatal case), one congenital infection was identified. Six patients had not traveled outside of the united states in over 1 year. CONCLUSION: Imported malaria occurs frequently and usually results from the failure to use appropriate prophylaxis. delayed diagnosis and misdiagnosis are common. Severe disease and fatal cases continue to be seen despite aggressive treatment. drug resistance has continued to spread and now occurs with P vivax as well as P falciparum.- - - - - - - - - - ranking = 1.7604754114565keywords = malaria, vivax (Clic here for more details about this article) |
8/18. malaria. Principles of prevention and treatment.In the united states, effective malaria prevention strategies for short-term travelers are available. Monitoring trends in imported malaria and continued evaluation of the effectiveness and chemoprophylaxis will allow prevention recommendations to evolve as the risk of infection and effectiveness of antimalarial drugs change. Our challenge is to increase the number of prospective travelers receiving pre-travel advice, to disseminate this information to health care providers, and to improve the quality of the advice given. The early recognition of Plasmodium infection and the institution of prompt and effective treatment will reduce morbidity and mortality from malaria in this country.- - - - - - - - - - ranking = 0.57142857142857keywords = malaria (Clic here for more details about this article) |
9/18. Management of chloroquine-resistant plasmodium falciparum malaria in a pregnant Ethiopian immigrant--a case report.plasmodium falciparum malaria is infrequently recognized in israel as a cause of infection during pregnancy. We expect that with increasing frequency physicians in israel will confront patients with malaria. Special concern should be given to malaria in pregnancy because of its serious complications. Thus, prompt diagnosis and treatment are essential. While chloroquine is safe for use in pregnancy, drug resistance is common, especially with plasmodium falciparum. There is concern about the safety of other antimalarial agents during pregnancy. We recently observed a case of chloroquine-resistant plasmodium falciparum malaria during pregnancy in a new immigrant primigravida from ethiopia. malaria in patients from endemic regions is less severe than in nonimmune hosts. Therefore, we elected to follow the patient's parasitemia periodically without additional antimalarial treatment until after delivery.- - - - - - - - - - ranking = 1.4285714285714keywords = malaria (Clic here for more details about this article) |
10/18. malaria in pregnancy--a master of masquerade.One case of malaria in pregnancy at 23 weeks of gestation in a woman returning from ghana is presented. The patient complained of diarrhea and abdominal pain and was admitted to the department of gynecology and obstetrics. Under suspicion of appendicitis an exploratory laparotomy was performed. Diagnosis was missed and treatment delayed five days. Outcome was favorable for both woman and fetus.- - - - - - - - - - ranking = 0.14285714285714keywords = malaria (Clic here for more details about this article) |
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