Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

In the last few years a considerable number of imported malaria has been reported in Spain, probably due the increased tourism to areas with endemic malaria, particularly with P. falciparum. This is the species more frequently associated with severe complications and the only one capable of causing cerebral malaria. In this report we review five cases of malaria which required intensive care because of their severity. None of the patients had received chemoprophylaxis. In all cases the admission criterion to the intensive care unit was the organic failure of one or more systems (renal failure and disseminated intravascular coagulation [DIC] mainly) or the presence of changes in the central nervous system. Parasitemia at admission was higher than 5% in all patients. One patient died on account of cerebral malaria. Only one patient had severe complications not directly associated with malaria. In patients who already have severity criteria, a negative parasitemia test during the clinical course does not necessarily implies a clinical improvement nor does it exclude the emergence of complications. On the other hand, a low parasitemic degree is never a contraindication for admission to the intensive care unit when severity criteria are present.
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PMID:[Severe Plasmodium falciparum malaria. Description of 5 cases]. 941 68

A 2-year-old, male, red-necked (Bennett's) wallaby (Macropus rufogriseus) from a zoological facility was presented for peracute onset of severe depression, unresponsiveness, ataxia, and loose feces. Serum biochemical abnormalities included azotemia, hypoalbuminemia, increased alanine aminotransferase activity, hyperbilirubinemia, hyperphosphatemia, and hyperkalemia, consistent with multi-organ system failure. Severe thrombocytopenia suggested possible disseminated intravascular coagulation. Peripheral blood smear examination revealed numerous ovoid, protozoal inclusions within monocytes and occasionally within neutrophils. Despite aggressive supportive therapy, the patent died within 5 hours of presentation. Gross necropsy and histopathologic findings included severe multifocal necrotizing lesions in multiple organs. Numerous intralesional protozoal organisms were observed and were identified as Toxoplasma gondii by immunohistochemistry. Macropods (wallabies and kangaroos) are known to be highly susceptible to toxoplasmosis, with high mortality rates; diagnosis most often is obtained at necropsy. Detection of protozoal organisms in peripheral blood leukocytes is reported rarely and has not been documented previously in a macropod. Parasitemia in this case was attributed to severe, disseminated disease. Careful examination of peripheral blood smears in macropods suspected of toxoplasmosis may be warranted.
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PMID:Toxoplasma gondii inclusions in peripheral blood leukocytes of a red-necked wallaby (Macropus rufogriseus). 1731 Dec 3