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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The spontaneous rupture of malarial spleen is an uncommon complication. It usually occurs to a child and a recent expatriate. Its diagnosis is misleading into a context of infection. A 28-year-old European man, newly affected to Gabon, under chimioprophylactic drugs by chloroquine and proguanil, has been hospitalized in September 2000 because of an acute attack of malaria to Plasmodium falciparum. After four days treatment by quinine, he presented an abdominal pain with a Sub capsular Haematoma of the spleen confirmed by Scanner. The evolution was favourable under conservative treatment. The spontaneous rupture of malarial spleen is caused by Plasmodium vivax and falciparum. Twenty cases are reported in the literature. Conservative management permits to preserve the role of the spleen in immune response especially of the child and of people who regularly travel to endemic zone.
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PMID:[Spontaneous spleen rupture in the course of malaria]. 1807 82

A 51-year-old male patient with living, unrelated kidney transplantation in Iran in June 2001, developed Plasmodium falciparum P. falciparum infection. He was maintained on cyclosporine A, mycophenolate mofetil, and prednisone. In August 2005, he was admitted to a medical facility in the local community with upper gastrointestinal bleeding, and received several units of blood and blood products. Two months later, he was referred to Dhahran Health Center, and admitted with fever, abdominal pain, dysuria, and severe fatigue. Plasmodium falciparum with a parasitemia of 70% was detected in the peripheral smear. He was treated with intravenous quinidine gluconate and oral doxycycline, in addition to blood transfusion, and he responded well to the treatment. An investigation was carried out to try to find the source of malaria infection, which is believed to be the blood or blood products that he received during his initial acute illness. Measures to minimize transfusion related malaria are discussed.
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PMID:Transfusion-transmitted malaria in a kidney transplant recipient. How safe is our blood transfusion? 1824 45

This paper describes ethnopharmacological knowledge on the uses of Erythrina senegalensis DC (Fabaceae) in traditional medicine in three different areas (Dioila, Kolokani and Koutiala) in Mali. Data were collected using interviews of traditional healers selected randomly. The main reported diseases for which E. senegalensis was used by the traditional healers were amenorrhea, malaria, jaundice, infections, abortion, wound, and body pain (chest pain, back pain, abdominal pain etc). The fidelity level (which estimates the agreement of traditional healers on the same area about a reported use of the plant) was calculated to compare the results from the three areas. Certain differences were noticed, the most striking was the fact that amenorrhea was the most reported disease in Dioila and Kolokani with 21% of agreement for both areas, while this use was not reported in Koutiala at all. Similarities existed between the three areas on the use of the plant against malaria and infections, although with different degree of agreement among the healers. We also report the results of a literature survey on compounds isolated from the plant and their biological activities. A comparison of these results with the ethnopharmacological information from Mali and other countries showed that some of the traditional indications in Mali are scientifically supported by the literature. For instance, the use of E. senegalensis against infectious diseases (bilharzias, schistosomiasis, pneumonia etc.) is sustained by several antibacterial and antifungal compounds isolated from different parts of the plant. The comparison also showed that pharmacologists have not fully investigated all the possible bioactivities that healers ascribe to this plant.
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PMID:Ethnopharmacological uses of Erythrina senegalensis: a comparison of three areas in Mali, and a link between traditional knowledge and modern biological science. 1832 74

Acute bilateral renal cortical necrosis is a rare cause of renal failure frequently induced by disseminated intravascular coagulation (Dic) following obstetrical complications, sepsis and drugs. We describe a case of Dic with bilateral cortical necrosis after ingestion of only one tablet of quinine. A 41-year-old woman was admitted for severe abdominal pain, melaena, fever and anuria two hours after quinine tablet intake for nocturnal leg cramps. Her medical history included angioneurotic edema caused by chloroquine for malaria prevention. Physical examination was normal. Laboratory data showed acute renal failure, hemolytic anemia without schistocytes and Dic. Platelet antibodies were negative. Ultrasonographic examination showed a complete defect of renal perfusion with permeable renal arteries. Results of abdominal CT scan and MAG3 scintigraphy led to the diagnosis of bilateral renal cortical necrosis. The patient underwent plasma exchanges with fresh frozen plasma which induced rapid resolution of Dic. She remained dependent on chronic hemodialysis. Quinine-induced microangiopathic hemolytic anemia and Dic is a rare described entity. These complications occur typically in quinine-sensitized subjects. The presence of acute renal failure is generally associated with poor prognosis in case of bilateral renal cortical necrosis. Caution is required for the prescription of quinine derivates, which should be avoided in patients experienced on adverse reaction to the drug.
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PMID:[Quinine-induced renal bilateral cortical necrosis]. 1834 36

Plasmodium falciparum infection is known to be associated with a spectrum of systemic complications ranging from mild and self-limiting to life-threatening. This case report illustrates a patient who had a protracted course in hospital due to several rare complications of falciparum malaria. A 21-year old man presented with a five-day history of high-grade fever, jaundice and abdominal pain and a two-day history of altered conscious state. A diagnosis of severe falciparum malaria was made based on the clinical presentation and a positive blood smear with parasitaemia of 45%. Despite adequate anti-malarial therapy with artesunate, the patient had persistent and worsening abdominal pain. Investigations suggested a diagnosis of acute pancreatitis, a rare association with falciparum malaria. However, in spite of supportive therapy for acute pancreatitis and a 10-day course of intravenous artesunate and oral doxycycline at recommended doses, he continued to be febrile with peripheral blood smear showing persistence of ring forms. Antimalarial therapy was, therefore, changed to quinine on the suspicion of possible artesunate resistance. On the 17th day of stay in hospital, the patient developed generalized tonic-clonic seizures. Computerized tomography of the brain showed bilateral fronto-parietal subdural haematomas that were surgically drained. His fever persisted beyond 30-days despite broad-spectrum antibiotics, quinine therapy and negative malarial smears. A possibility of drug fever was considered and all drugs were ceased. He subsequently became afebrile and was discharged on the 38th hospital admission day. Recognition of complications and appropriate management at each stage facilitated successful outcome. This report has been presented to highlight the occurrence of several rare complications of falciparum malaria in the same patient.
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PMID:Acute pancreatitis and subdural haematoma in a patient with severe falciparum malaria: case report and review of literature. 1851 Jul 78

A 38 year old patient presented with fever, myalgic abdominal pain, nose bleeding and acute renal failure since five days. A combination of thrombocytopenia, proteinuria, elevated CrP and creatinin is common in hemorrhagic fever with renal syndrome (HFRS) due to Hantavirus infection. The benigne form is called Nephropathia epidemica. Dialysis is infrequently required by patients with the Puumala virus. Other infection (e.g. malaria, leptospirosis, yellow fever) and systemic diseases (e.g. collagenosis or vasculitis) are considered.
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PMID:[Fever, nosebleeding and myalgic abdominal pain]. 1854

In 2001, Peru changed its treatment policy for uncomplicated Plasmodium falciparum malaria on the northern Pacific Coast to sulfadoxine-pyrimethamine with atresunate (SP-AS). Because Peru was the first country in the Americas to adopt this combination therapy, we established a surveillance system in the region to assess the frequency of new or worsening symptoms after starting therapy. Over a period of two years, 1,552, or approximately two-thirds of all patients with uncomplicated P. falciparum malaria who had received SP-AS on the northern coast were followed up. Of these, 8.8% reported at least one adverse effect, with the most common being vomiting, nausea, headache, abdominal pain, dizziness, and fever; no severe adverse effects related to SP-AS therapy were identified. Treatment of uncomplicated malaria with SP-AS was associated with a low frequency of mild adverse effects in Peru, and therefore should be considered as a first-line therapy in areas of the Americas where SP efficacy is still high.
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PMID:Surveillance for adverse drug reactions to combination antimalarial therapy with sulfadoxine-pyrimethamine plus artesunate in Peru. 1860 62

Malaria is a rare cause of splenic infarction. Only a few cases have been reported worldwide, mostly associated with Plasmodium falciparum infection. Here we report a series of four acute malaria patients with splenic infarction, two with P. vivax infection, one with P. falciparum and one with a mixed infection (P. vivax and P. falciparum). This small case series suggests that if a patient with malaria is complaining of left upper quadrant abdominal pain, pleuritic left lower chest pain and/or enlarging tender splenomegaly during treatment, splenic infarct should be suspected and managed accordingly to avoid further life-threatening complications.
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PMID:A case series of splenic infarction during acute malaria in northwest Rajasthan, India. 2067 39

Pediatric drug formulations of artemisinin combination therapies are urgently needed for improving the treatment of children suffering from uncomplicated malaria. The aim of this clinical trial was to evaluate the efficacy, safety and tolerability of a novel pediatric fixed-dose granule formulation of artesunate-mefloquine and a new co-blister tablet formulation. A total of 71 children aged 1-13 years suffering from uncomplicated falciparum malaria were stratified into two groups according to weight: 10-20 kg, pediatric group (n = 41); 20-40 kg, tablet group (n = 30). All the children were treated once daily for three days: the pediatric group received the novel granule formulation, the tablet group received the co-blister tablets. The PCR-corrected cure rate on day 28 was evaluated. There was no reappearance of parasitemia during the follow-up period and the day-28 cure rate was therefore 100% in per-protocol analysis. In intention-to-treat analysis the cure rates were 95% in the pediatric group and 97% in the tablet group. The most frequent adverse events were vomiting (17%), abdominal pain (11%) and headache (17%). This study confirms the excellent efficacy and favorable safety and tolerability profile of a novel pediatric artesunate-mefloquine formulation for treatment in African children.
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PMID:Efficacy and safety of a new pediatric artesunate-mefloquine drug formulation for the treatment of uncomplicated falciparum malaria in Gabon. 2036 81

Artemisinin-based combination therapies (ACT) are now being adopted as first-line treatments against uncomplicated malaria in sub-Saharan Africa. Between December 2009 and February 2010, the efficacies of two ACT - dihydroartemisinin-piperaquine (DHA-P) and artemether-lumefantrine (AL) - in the treatment of uncomplicated Plasmodium falciparum malaria were compared in Sinnar, central Sudan. Overall, 149 patients (75 given DHA-P and 74 given AL) completed the 28 days of follow-up. All the patients were found to be afebrile and aparasitaemic on day 3. By day 28, only one patient, who had been given AL, showed late treatment and parasitological failures, while each of the other 148 patients showed an adequate treatment response. After the results of a PCR-based assay confirmed that the recrudescent parasitaemia was probably the result of treatment failure, the frequencies of cure by day 28 were calculated as 100% for DHA-P and 98.7% for AL (P>0.05). None of the patients was found gametocytaemic during the follow-up, and the adverse effects observed were mild (nausea, vomiting, abdominal pain, dizziness and/or rash), resolved spontaneously and occurred in only five patients in each treatment arm. Thus, both treatments appeared effective and safe for the treatment of uncomplicated P. falciparum malaria in central Sudan, although treatment with DHA-P (which requires a simpler dosing regimen) might be preferred to treatment with AL.
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PMID:Dihydroartemisinin-piperaquine versus artemether-lumefantrine, in the treatment of uncomplicated Plasmodium falciparum malaria in central Sudan. 2065 92


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