Bacteremia in Kenyan Children Presenting with Malaria

Were, Tom; Davenport, Gregory C.; Hittner, James B.; Ouma, Collins; Vulule, John; Ong’echa, John Michael; Perkins, Douglas J

doi:10.1128/jcm.01864-10

Cited by 116 publications

(178 citation statements)

References 34 publications

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“…Yapılan çalışmalarda sıtma olgularında bakteriyemi varlığında mortalitenin arttığı bildirilmektedir (17). Olgularımız-dan birinde olduğu gibi, sıtmada özellikle Gram-negatif etkenlerle bakteriyeminin daha sık görüldüğü bildirilmektedir.…”

Section: İrdelemeunclassified

Plasmodium falciparum Malaria of Foreign-Origin in Kocaeli Province: Assessment of 16 Cases

Altunok¹,

Aynıoğlu²,

Karali³

et al. 2016

Klimik Dergisi

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Objective: This paper intends to underline that malaria should be borne in mind in the differential diagnosis of patients with history of visiting endemic regions and of malaria prophylaxis for those intending to travel to these regions. Methods: 16 cases of P. falciparum malaria that were followed in the clinic between 2009 and 2015 were included in our study. Diagnosis was based on plasmodia seen under light microscope in thick and thin smears prepared from peripheral blood samples obtained from febrile patients and stained with Giemsa method. Results: Out of 16 patients, one was female and 15 were males. 14 of these patients, whose average age was 32 years, did not receive prophylaxis. Complaints of all patients were fever with chills, rigor, weakness, and anorexia; other accompanying complaints were headache, nausea, abdominal pain, diarrhea, cough and sore throat. Body temperatures over 38°C were detected in all patients. 11 patients were treated with artemether-lumefantrin and 5 patients treated with combination of quinine and doxycycline. Ertapenem was added in the treatment of a patient due to Serratia marcescens isolation in his blood culture obtained during his febrile period. Acute hepatitis A as a co-infection was detected in a patient and he was followed with symptomatic treatment. Somnolence, bleeding, bilateral pleural effusion and pulmonary infiltrates were observed in two patients diagnosed as severe malaria. Conclusions: Malaria chemoprophylaxis for the people intending to travel endemic regions is crucial. Klimik Dergisi 2016; 29(2): 86-9.

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Section: İrdelemeunclassified

Plasmodium falciparum Malaria of Foreign-Origin in Kocaeli Province: Assessment of 16 Cases

Altunok¹,

Aynıoğlu²,

Karali³

et al. 2016

Klimik Dergisi

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“…nvasive bacterial infections have been associated with high mortality in children with severe malaria in sub-Saharan Africa (1)(2)(3)(4)(5). Recently, malaria has been shown to strongly predispose children in areas of malaria endemicity to bacteremia (6).…”

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confidence: 99%

Bacterial Coinfections in Travelers with Malaria: Rationale for Antibiotic Therapy

et al. 2013

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e Malaria predisposes children in areas where malaria is endemic to concurrent bacteremia, often with severe outcomes. The importance of bacterial coinfections in patients diagnosed with malaria in nonendemic settings has, however, not been reported. A retrospective analysis of microbiology data was performed in 755 travelers diagnosed with malaria in Sweden. Bacterial cultures from blood and other locations were correlated to clinical outcome and antibiotic treatment. Blood cultures were drawn from 417 (55%) patients (88% of whom were >15 years old), and bacterial isolates of clinical relevance (Salmonella enterica serovar Enteritidis and Escherichia coli) were detected in 2 patients (0.3%). Cultures from other locations (mainly urine, nasopharyngeal, and fecal samples) were obtained from 44% of the patients with 4.9% positivity. Of the 38 patients given antibiotics, 47% had neither severe malaria nor positive cultures and/or radiology signs indicative of treatment. C-reactive protein levels were associated with bacterial infections but had only a fair predictive value. Bacterial coinfections are uncommon among travelers with malaria. These data suggest a weaker association between malaria and bacteremia than previously described in endemic settings and might indicate different patient populations with different pathophysiological mechanisms and microbial environments. The study supports a restrictive antibiotic policy in returning travelers with malaria.

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“…Current WHO treatment guidelines suggest a low threshold for beginning antibiotic therapy in these children. Patients in whom antibiotics should be strongly considered include those who are severely anemic and have deep breathing, are malnourished or exhibit signs of shock [37,65,66]. A child that clears parasites and remains febrile may warrant commencement of antibiotics.…”

Section: Antibioticsmentioning

confidence: 99%

“…Salmonella is the most common bacterial coinfection in children with severe malaria [63][64][65]. Current WHO treatment guidelines suggest a low threshold for beginning antibiotic therapy in these children.…”

Section: Antibioticsmentioning

confidence: 99%

Pediatric Cerebral Malaria: A Scourge of Africa

et al. 2012

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Cerebral malaria, defined as an otherwise unexplained coma in a patient with Plasmodium falciparum parasitemia, affects up to 1 million people per year, the vast majority of them being children living in sub-Saharan Africa. Despite optimal treatment, this condition kills 15% of those affected and leaves 30% of survivors with neurologic sequelae. The clinical diagnosis is hampered by its poor specificity, but the presence or absence of a malarial retinopathy in cerebral malaria has proven to be important in the differentiation of underlying coma etiology. Both antimalarials and intense supportive care are necessary for optimal treatment. As of yet, clinical trials of adjunctive therapies have not improved the high rates of mortality and morbidity. Survivors are at high risk of neurologic sequelae including epilepsy, neurodisabilities and cognitive–behavioral problems. The neuroanatomic and functional bases of these sequelae are being elucidated. Although adjunctive therapy trials continue, the best hope for African children may lie in disease prevention. Strategies include bednets, chemoprophylaxis and vaccine development.

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Bacteremia in Kenyan Children Presenting with Malaria

Cited by 116 publications

References 34 publications

Plasmodium falciparum Malaria of Foreign-Origin in Kocaeli Province: Assessment of 16 Cases

Plasmodium falciparum Malaria of Foreign-Origin in Kocaeli Province: Assessment of 16 Cases

Bacterial Coinfections in Travelers with Malaria: Rationale for Antibiotic Therapy

Pediatric Cerebral Malaria: A Scourge of Africa

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