Malária álgida: um diagnóstico sindrômico

Lacerda, Marcus Vinícius Guimarães; Mourão, Maria Paula Gomes; Santos, P. J. T.; Alecrim, Maria das Graças Costa

doi:10.1590/s0037-86822009000100017

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…Additionally, this fact can result from compensatory physiological effects, such as the vasoconstriction caused by NO inhibition, which seems to stimulate the release of mediators that cause vasodilation, such as acetylcholine and bradykinin, which, however, are bronchoconstrictors. On the other hand, it is possible that the occurrence of pulmonary hypertension in malaria, a side effect of NO inhibition as reported by Lacerda et al (2009) combined with the need for oxygen as a result of hemolysis, stimulates the synthesis of endothelial nitric oxide synthase (eNOS) by erythropoietin, which increases the expression of eNOS receptors in the lung (Beleslin-Čokić et al, 2011). Another important factor to be considered is the existence of a complex system of non-adrenergic non-cholinergic (NANC) neural fibres in mammalian lungs capable of producing significant quantities of NO (Gaston et al, 1994) that overcome malaria-derived NO synthesis in this tissue.…”

Section: Discussionmentioning

confidence: 97%

Inhibition of nitric oxide synthesis promotes increased mortality despite the reduction of parasitemia in Plasmodium berghei-infected mice

Barbosa

Temple

Varela

et al. 2021

RSD

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Nitric oxide (NO) is an important mediator molecule in inflammatory processes, but its role in the pathophysiology of malaria is still uncertain. To investigate the NO synthesis inhibition on the oxidative changes induced by Plasmodium berghei infection in mice, malaria was induced in 150 animals, of which 75 animals were treated with the NO inhibitor L-NAME; the remaining animals were sham controls. All animals underwent euthanasia 1, 5, 10, 15, or 20 days after infection for the collection of lungs, brain, and blood. Parasitemia was determined, and the survival of the animals was evaluated. Tissue samples were assayed for nitrites and nitrates (NN), thiobarbituric acid reactive substances (TBARS), and total Trolox equivalent antioxidant capacity (TEAC). A histopathological study was performed. Mortality rates in the L-NAME group were always higher than those in the controls. In the brain, NN was lower in the L-NAME group. Parasitemia and its progression rate were greater in the control group. By the 5th day of infection, mice treated with L-NAME showed cerebral edema and interstitial pneumonia of greater intensity than controls. In conclusion, the anti-inflammatory and hemodynamic effects of NO surpass its pro-oxidant role in murine malaria.

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Section: Discussionmentioning

confidence: 97%

Inhibition of nitric oxide synthesis promotes increased mortality despite the reduction of parasitemia in Plasmodium berghei-infected mice

Barbosa

Temple

Varela

et al. 2021

RSD

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“…Even for P. falciparum malaria, the etiology of this complication is uncertain and the potential role of septic shock as a concomitant entity has been proposed [31]. In such cases therefore, blood cultures are mandatory to rule out bacterial co-infections, which may be related to severity and consequently to ICU hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon

et al. 2012

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Background Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs) in the Western Brazilian Amazon, and to identify risk factors associated with disease severity.Methods and FindingsIn this retrospective study, clinical records of 34 children, 0–14 years of age hospitalized in the 11 public pediatric and neonatal ICUs of the Manaus area, were reviewed. P. falciparum monoinfection or P. falciparum/P. vivax mixed infection was diagnosed by microscopy in 10 cases, while P. vivax monoinfection was confirmed in the remaining 24 cases. Two of the 24 patients with P. vivax monoinfection died. Respiratory distress, shock and severe anemia were the most frequent complications associated with P. vivax infection. Ninety-one children hospitalized with P. vivax monoinfections but not requiring ICU were consecutively recruited in a tertiary care hospital for infectious diseases to serve as a reference population (comparators). Male sex (p = 0.039), age less than five years (p = 0.028), parasitemia greater than 500/mm3 (p = 0.018), and the presence of any acute (p = 0.023) or chronic (p = 0.017) co-morbidity were independently associated with ICU admission. At least one of the WHO severity criteria for malaria (formerly validated for P. falciparum) was present in 23/24 (95.8%) of the patients admitted to the ICU and in 17/91 (18.7%) of controls, making these criteria a good predictor of ICU admission (p = 0.001). The only investigated criterion not associated with ICU admission was hyperbilirubinemia (p = 0.513)].ConclusionsOur study points to the importance of P. vivax-associated severe disease in children, causing 72.5% of the malaria admissions to pediatric ICUs. WHO severity criteria demonstrated good sensitivity in predicting severe P. vivax infection in this small case series.

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“…(36) Shock in Plasmodium falciparum infected patients is known as algid malaria syndrome, which may be associated with acute adrenal insufficiency, myocardial failure, acute pulmonary edema and profuse bleeding caused by either disseminated intravascular coagulation or the rupture of a subcapsular hematoma of the spleen. (56) This is a rare complication that is triggered by several mechanisms, including concomitant bacterial infection, (1) dehydration and glucocorticoid deficit due to acute adrenal insufficiency. (56)…”

Section: Pulmonary Dysfunctionmentioning

confidence: 99%

“…(56) This is a rare complication that is triggered by several mechanisms, including concomitant bacterial infection, (1) dehydration and glucocorticoid deficit due to acute adrenal insufficiency. (56)…”

Section: Pulmonary Dysfunctionmentioning

confidence: 99%

Malária grave por Plasmodium falciparum

Gomes¹,

Vitorino²,

Costa³

et al. 2011

Rev. bras. ter. intensiva

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Malaria is one of the world's leading parasitic diseases and affects a considerably large number of people. Considering the epidemiological reach of Plasmodium falciparum, which is almost always responsible for the most severe cases of malaria, a discussion of the clinical features and therapeutic interventions is important. In the cases of patients with severe malaria, admission to an intensive care unit is mandatory to reduce complications. To have an impact on survival rates, treatment with antimalarial drugs and supportive measures should be initiated as quickly as possible. The aim of this article is to discuss the components of severe malaria, with an emphasis on its clinical features and treatment.

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Malária álgida: um diagnóstico sindrômico

Cited by 7 publications

References 9 publications

Inhibition of nitric oxide synthesis promotes increased mortality despite the reduction of parasitemia in Plasmodium berghei-infected mice

Inhibition of nitric oxide synthesis promotes increased mortality despite the reduction of parasitemia in Plasmodium berghei-infected mice

Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon

Malária grave por Plasmodium falciparum

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