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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the years 1968 to 1973 70 patients suffering from malaria were admitted to one hospital in England. Twenty had malignant tertian malaria while the remainder had infections caused by Plasmodium vivax, P. ovale and P. malariae. Malaria should be suspected in every febrile patient who has visited a tropical country, and the diagnosis can be confirmed only by examining blood films. Disseminated intravascular coagulation may complicate the disease, and should be considered in every case.British workers spending short periods in malarious areas and Asian immigrants returning home for a holiday are often inadequately instructed about malarial prophylaxis, particularly the need to continue this for at least a month after they return home. Companies and travel agencies should be obliged to provide such instructions.
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PMID:Malaria in Birmingham 1968-73. 459 59

The mechanism of thrombocytopenia in six patients with falciparum malaria has been studied. All the patients recovered after antimalarial therapy, and cerebral malaria was not a feature. Radioactive-labelled platelets and fibrinogen were injected into the patients during the phase of thrombocytopenia. In all cases recovery of injected platelets was notably subnormal, indicating excessive splenic pooling of platelets. Platelet life span was moderately shortened in all patients, and platelet turnover increased approximately two-fold. Fibrinogen catabolism was moderately increased in all patients, but coagulation tests failed to reveal evidence of disseminated intravascular coagulation. The results suggest that in uncomplicated cases of malaria thrombocytopenia is the result of splenic pooling of platelets aggravated by a moderate decrease in platelet life span. In such cases thrombocytopenia is thus not the result of disseminated intravascular coagulation (D.I.C.), and heparin therapy is not indicated unless there is unequivocal ancillary evidence of D.I.C.
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PMID:Mechanisms of thrombocytopenia in malignant tertian malaria. 471 66

A fatal female case of cerebral falciparum malaria who was accidentally, artificially and directly infected in Japan through nursing an imported falciparum malaria was experienced. These observations raised a question as to whether the disseminated intravascular coagulation (DIC) would occur in falciparum malaria. Then, 84 Congolese patients with uncomplicated falciparum malaria were studied on the coagulation. Serum fibrin-degradation products (FDP) levels were only slightly raised (10-40 microgram/ml) in 4 cases out of 84 (5%). Thrombocytopenia, elongation of prothrombin time and low fibrinogen concentration were found in 24 out of 57 (42%), in 11 out of 47 (23%) and in 11 out of 46 (24%), respectively. Relations between FDP level and the other observations were not significant. It is suggested that there is no evidence of intravascular coagulation at least in uncomplicated falciparum malaria.
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PMID:Fibrin-degradation products in falciparum malaria. 703 50

An unusual case of malaria with Plasmodium vivax is reported which had complications classically seen with Plasmodium falciparum malaria. The complications were cerebral malaria, disseminated intravascular coagulation and adult respiratory distress syndrome.
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PMID:Unusual complications in benign tertian malaria. 748 8

Falciparum malaria is the most hazardous form of malaria. Its high degree of parasitemia interferes with vital functions of most organs and is directly responsible for its high rate of mortality and morbidity. Quinine and other antimalarial drugs are relatively slow acting and not always effective due to the growing resistance developed by Plasmodium toward these drugs. Another emergency modality, which would remove the parasitic burden quickly and effectively, is thus much needed. We present a case of a 51-year-old sailor, who was admitted to the hospital because of complicated falciparum malaria. His situation deteriorated rapidly into a desparate stage, despite the various intensive treatments and quinine. He soon developed a systemic inflammatory response syndrome manifested as cerebral malaria, renal failure, acute respiratory distress syndrome and disseminated intravascular coagulation. An emergency blood exchange reversed the situation dramatically, and the patient recovered completely. It is recommended that any doctor, both in endemic and in non endemic areas, dealing with blood transfusions or infectious diseases, should be acquainted with this lifesaving modality, regardless of the controversy still surrounding this subject.
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PMID:Blood exchange [correction of exchance]-a rescue procedure for complicated falciparum malaria. 772 67

A 45-year-old Japanese male, who had been to the Central African Republic, was admitted to our hospital because of high fever with chills on July 29, 1994. He used chloroquine as a malaria prophylaxis during his stay and for 6 weeks after his return to Japan. On admission, Plasmodium ovale was detected in his blood smears and in the DNA analysis. He was treated successfully with chloroquine (1500 mg over 3 day period) and primaquine (15 mg/day for 14 days beginning day 4). Disappearance of malarial parasites in the peripheral blood smear occurred on the third day and his temperature returned to normal on the 4th day. Interestingly, he had thrombocytopenia and an abnormal grade in fibrin degradation products (FDP) concentration. This led to the suspicion of disseminated intravascular coagulation (DIC). This report indicates the importance of thrombocytopenia which may develop into DIC even though P. ovale malaria infection rarely becomes severe. This is the second report of a P. ovale malaria case in the Central African Republic.
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PMID:[A case of Plasmodium ovale malaria with thrombocytopenia and an abnormality grade in FDP concentration despite the use of chloroquine as a malaria prophylaxis]. 775 55

In a retrospective study we analyzed the clinical and blood chemical data of 12 patients with severe tropical malaria in the intensive care units of the University Hospital Zurich and the Stadtspital Triemli, Zurich, between 1991 and 1994. None of the 12 patients had been exposed to malaria before or had taken drugs for chemoprophylaxis. 7 patients survived, 5 died from complications of malaria. According to the criteria of severe tropical malaria defined by the WHO, the following pathological clinical and blood chemical parameters were noted on admission: cerebral coma (2/12); blood hemoglobin < 5 g/dl (0/12), < 8 g/dl (2/12); serum creatinine > 265 mumol/l (3/12); blood glucose < 2.2 mmol/l (0.12); circulatory collapse/shock (0/12); bleeding/signs of disseminated intravascular coagulation in laboratory tests (4/12); acidosis with pH < 7.25 (1/12). Further signs of severe tropical malaria were: hyperparasitemia > 5% (9/12); qualitative and quantitative disturbances of consciousness (6/12); thrombocytopenia < 30 x 10(9)/l (9/12); hyponatremia 125-135 mmol/l (9/12), < 125 mmol/l (2/12); rhabdomyolysis with creatine kinase > 1000 U/l (4/12). The basic treatment consisted of parenteral quinine hydrochloride in all patients; doxycycline was added in 8 cases, clindamycin in 3. Adjuvant therapy with desferrioxamin was given in 3 cases. 6 patients had exchange transfusions. Parasitemia cleared in all patients within 5 to 6 days. Later in the course, 5 patients developed acute respiratory distress syndrome, 6 required hemofiltration due to oliguria, and one became comatose.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intensive care aspects in severe tropical malaria: clinical aspects, therapy and prognostic factors]. 777 Jul 59

The authors describe a malignant malaria clinic case complicated by shock, disseminated intravascular coagulation (DIC) and multiple organ failure (renal, heart, lung failure): MOF. Early diagnosis and suitable therapy, with multiple organ failure intensive care allowed a good patient outcome.
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PMID:[Multiple organ failure (MOF) in tertian malaria. Report of a clinical case]. 780 Jan 89

Nine cases of severe complicated falciparum malaria treated by exchange transfusion were studied. Eight patients survived and one patient died. Multisystemic complications were found in all cases. The CNS complications, acute renal failure, pulmonary insufficiency, jaundice, bleeding, sepsis, and DIC were found in 9, 7, 5, 7, 2, 4 and 1 cases, respectively. The fatal case presented with severe multisystemic complications together with 40% parasitemia. In eight survivors, whose parasitemia ranged from 0.3%, to 90%, had milder degrees of systemic complications. With the use of blood exchange 10-15 units, the parasitemia was decreased to less than 5% within 24 hours in all expect one who had parasitemia 90%. In comparison with the other 10 matched non-exchanged patients, there was no significant difference in survival rate between these two group (89% vs 80%). However, in the patients with ARDS the survival rate in the group who received the exchange transfusion therapy was superior (75% vs 0%). The exchange transfusion therapy is therefore strongly recommended in the treatment of malarial patients who present with parasitemia > 30% and severe systemic complications, particularly those who have severe acute renal failure or have lung complications. The amount of blood used for exchange transfusion should at least 1.2 times the blood volume for rapid removal of parasites and toxic metabolites from the circulation.
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PMID:Exchange transfusion therapy in severe complicated malaria. 788 48

A simplified technique using DEAE-cellulose chromatography for the preparation of factor VII deficient substrate was developed in order to reduce the high cost of individual factor VII assay in the routine coagulation laboratory. The substrate prepared from cryo-removed human and bovine plasma had a high correlation (r = 0.9929) with two of the most popular imported commercial substrates available (DADE, Ortho). When compared several other imported commercial substrates of equal quality, the prepared substrate was 3,000 to 6,000 times cheaper. Using the prepared factor VII deficient substrate along with other commercial substrates available, two hundred and fifty patients with malaria (fifty cases of P. vivax and two hundred cases of P. falciparum) were studied for coagulation and fibrinolysis abnormalities. Only P. falciparum infections showed prolonged PT and aPTT which correlated with the degree of parasitemia (r = 0.0972). Factors V, VII, and IX were the most sensitive parameters in the expression of coagulation defects and most coagulation abnormalities were due to liver involvement. Plasmin activity was normal in P. vivax patients but it was significantly increased in P. falciparum patients with > 5% parasitemia. Only two of the complicated cases of P. falciparum patients showed the evidence of DIC.
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PMID:A new method for factor VII deficient substrate preparation and coagulation studies in malaria. 788 82


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