Pulmonary Manifestations of Uncomplicated Falciparum and Vivax Malaria: Cough, Small Airways Obstruction, Impaired Gas Transfer, and Increased Pulmonary Phagocytic Activity

Anstey, Nicholas M.; Jacups, Susan P.; Cain, Tim; Pearson, T. A.; Ziesing, Patrick; Fisher, Dale; Currie, Bart J.; Marks, Paul J.; Maguire, Graeme

doi:10.1086/339885

Cited by 130 publications

(153 citation statements)

References 47 publications

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“…The low frequency of neurological disorders among patients seen in the ambulatory contrasts with the high (58%) proportion among those hospitalized. Similarly, the occurrence of alterations in the respiratory, liver, and kidney functions are consistent with data reported by other authors in relation to malaria by Plasmodium vivax 8,18,19 . Noteworthy is the finding of jaundice in 2.1% of patients treated in ambulatory and in 58% of hospitalized patients, a sign that can lead to misdiagnosis, as observed in some patients who received an initial diagnosis of hepatitis.…”

Section: Rev Soc Bras Med Trop 46(1):67-72 Jan-feb 2013supporting

confidence: 92%

Plasmodium vivax malaria: related factors to severity in the State of Maranhão, Brazil

Raposo

Santos

Santos³

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Introduction: Malaria caused by Plasmodium vivax species has shown signs of severity, recorded with increasing frequency in the medical literature. This study aimed to characterize the signs of severe malaria by Plasmodium vivax in the State of Maranhão, Brazil. Methods: A descriptive cohort study of patients assisted in the field and a historical and concurrent study of a series of cases among hospitalized patients were undertaken to identify the clinical and laboratory signs of severity. Results: A total of 153 patients were included in the study, 13 of whom were hospitalized. Males made up the majority, numbering 103 (67.3%). The age of the patients ranged from 10 to 70 years, 92.2% were natives of the State of Maranhão, and 65% of the patients had had malaria before. The average time elapsed between symptom onset and diagnosis among outpatients was three days, while among hospitalized patients this average reached 15.5 days, a statistically significant difference (p=0.001). The parasitemia ranged from 500 to 10,000 parasites/µl in 92.8% of cases. The clinical and laboratory manifestations of severity were vomiting and diarrhea, jaundice, drowsiness, mental confusion, seizures, loss of consciousness, agitation, bleeding, pale skin, coughing and dyspnea, thrombocytopenia, anemia, elevation of nitrogenous compounds, and elevated transaminases and bilirubin. Conclusions: The monitoring of malaria patients with Plasmodium vivax showed the possibility of aggravation, the intensity of which varied in different circumstances, especially the interval time between falling ill and diagnostic confirmation.

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Section: Rev Soc Bras Med Trop 46(1):67-72 Jan-feb 2013supporting

confidence: 92%

Plasmodium vivax malaria: related factors to severity in the State of Maranhão, Brazil

Raposo

Santos

Santos³

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…Se sugiere que en ellos hay un mecanismo inflamatorio de base. La obstrucción de las vías aéreas pequeñas, la alteración de la ventilación pulmonar, la disminución del intercambio gaseoso y el aumento de la actividad fagocitaria pulmonar, son los mecanismos que explican la alteración de la función pulmonar (31). Según el grado de compromiso, ésta puede producir desde un cuadro respiratorio simple hasta uno grave de edema pulmonar agudo o síndrome de dificultad respiratoria del adulto.…”

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Clinical and laboratory profile of Plasmodium vivax malaria patients hospitalized in Apartadó,

et al. 2012

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Introducción. La malaria representa un problema de salud pública en la región de Urabá, donde se registran tasas superiores a las del departamento de Antioquia; la carga de malaria por Plasmodium vivax es de 78,7 % y poco se ha explorado su perfil en la región.Objetivos. Con el presente estudio se pretende conocer las características clínicas y de laboratorio de los pacientes hospitalizados por malaria por P. vivax en Apartadó.Materiales y métodos. Se revisaron las historias clínicas de pacientes con malaria por P. vivax que requirieron manejo hospitalario en el Hospital “Antonio Roldán Betancur”, Empresa Social del Estado, durante los años 2004-2007.Resultados. Se hospitalizaron 359 pacientes con malaria por P. vivax, de los cuales, el 23,1 % (83/359 casos) se complicó por anemia grave (51,8 %, 43/83), por trombocitopenia grave (15,6 %, 13/83) y por hiperbilirrubinemia (7,2 %, 6/83); algunos pacientes satisfacían varios criterios simultáneamente, incluyendo un caso de síndrome de dificultad respiratoria aguda. Los datos de laboratorio más significativos mostraron disminución de los niveles de hemoglobina, hematocrito y plaquetas, con aumento en los niveles de transaminasas y bilirrubinas. Sólo el 4,82 % (4/83) de los pacientes con malaria complicada, recibió tratamiento con quinina intravenosa, ninguno falleció.Conclusiones. Se destaca en este trabajo la frecuencia importante de malaria complicada por P. vivax, particularmente en los menores de cinco años, en la región de Urabá, y la necesidad de fortalecer el conocimiento de la guía para la atención clínica integral del paciente con malaria, entre el personal de salud, para hacer un diagnóstico clínico correcto y ofrecer el tratamiento apropiado.

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“…35 Respiratory distress may DIC = disseminated intravascular coagulation; RRT = renal replacement therapy; CXR = chest radiograph; ABG = arterial blood gas; ECG = electrocardiogram; GCS = Glasgow Coma scale; ICP = intracranial pressure Perioperative considerations of malaria 311 occur in up to 20% of adults with severe falciparum malaria, though less frequently with vivax and ovale malaria. 36,37 Respiratory compromise is usually a multifactorial process arising from a combination of severe anemia, non-cardiogenic pulmonary edema, coexisting pneumonia, and the respiratory compensation resulting from the metabolic acidosis.…”

Section: Pulmonarymentioning

confidence: 99%

Perioperative considerations of the patient with malaria

Soltanifar

Carvalho

Sultan

2014

Can J Anesth/J Can Anesth

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Purpose Malaria is a life-threatening infectious disease caused by the Plasmodium parasite. Increased global travel has resulted in an escalation in the number of imported cases seen in developed countries. Patients with malaria may present for surgery in both endemic and nonendemic countries. This article reviews the perioperative considerations when managing patients with malaria. Source A literature review of anesthesia, perioperative care, and malaria-related articles was performed using the MEDLINE Ò , EMBASE TM , and Web of Science databases to identify relevant articles published in English during . Of the 303 articles matching the search criteria, 265 were excluded based on title and abstract. Eleven of the remaining 38 articles were relevant to anesthesia/perioperative care, and 27 articles were identified as having direct relevance to critical care medicine. Principal findings The majority of imported malaria cases are caused by the falciparum species, which is associated with the greatest degree of morbidity and mortality. Various organ systems may be impacted as a consequence of changes in the structure and function of parasitized erythrocytes. Preoperative assessment should focus on establishing the species of malaria, the severity of disease, assessing the degree of end-organ impairment, and initiating treatment of malaria prior to surgery. Intravenous artesunate is the treatment of choice for severe falciparum malaria. Quinine is a second-line agent but has a narrow therapeutic index and particularly hazardous side effects. Intraoperatively, attention should focus on fluid management, dynamics of cerebral blood flow, and avoidance of hypoglycemia. Postoperative care of severe cases should ideally take place in a critical care unit as there may be ongoing requirements for multi-organ support, including renal replacement therapy, ventilation, and/or inotropic support. The safety of neuraxial anesthesia has not been well studied in the setting of malaria. Conclusions Malaria remains one of the most devastating infectious diseases worldwide. Multiple organ systems can be impacted as a consequence of changes in structure and function of parasitized erythrocytes. Safe perioperative management requires a sound knowledge of all these potential system effects. RésuméObjectif Le paludisme est une maladie infectieuse possiblement fatale due au parasite Plasmodium. La multiplication des voyages à travers le monde a entraîné un accroissement du nombre de cas importés observés dans les pays développés. Les patients atteints de paludisme peuvent nécessiter une chirurgie, aussi bien dans les pays où la maladie est endémique que dans les autres. Cet article passe en revue les considérations périopératoires lors de la prise en charge de patients atteints de paludisme. Source Une revue de la littérature à la recherche d'articles d'anesthésie, de soins périopératoires et en Author contributions Daniel Soltanifar, Brendan Carvalho, and Pervez Sultan all made substantial contributions to the literature review, ...

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Pulmonary Manifestations of Uncomplicated Falciparum and Vivax Malaria: Cough, Small Airways Obstruction, Impaired Gas Transfer, and Increased Pulmonary Phagocytic Activity

Cited by 130 publications

References 47 publications

Plasmodium vivax malaria: related factors to severity in the State of Maranhão, Brazil

Plasmodium vivax malaria: related factors to severity in the State of Maranhão, Brazil

Clinical and laboratory profile of Plasmodium vivax malaria patients hospitalized in Apartadó,

Perioperative considerations of the patient with malaria

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