Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019214 (hepatosplenomegaly)
 4,408 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The "eradication of malaria" in Taiwan was announced by WHO in 1965. From 1966 to 1989, 919 malaria cases were detected in Taiwan. Of these cases, 803 were classified as imported malaria. During 1977 to 1989, our hospital collected 11 cases of imported malaria, 6 of Plasmodium falciparum (PF), including 1 suspicious case, 2 of Plasmodium vivax (PV), 1 of mixed infection (PF plus PV), and 2 unclassified. Most of the patients presented clinically with fever and chills. Hepatosplenomegaly was the most common abnormal finding during the physical examination. Jaundice and anemia occurred in the more severe cases. No cases had lymphadenopathy which is helpful in making a differential diagnosis. Six cases had thrombocytopenia which may be considered as an indirect sign in the diagnosis. The MCV levels were within normal limits in all of the cases. This may indirectly imply a potential protective effect against malaria infection in cases of congenital hemoglobinopathy such as thalassemia or G6PD deficiency. Initially, 10 cases were given "standard treatment", which consisted of chloroquine 450 mg qd for 2 days then 300 mg qd for 2 days and primaquine 15 mg qd for 2 weeks. Four cases of chloroquine resistance were encountered, all in cases with PF infection. Two cases were grade I delayed type resistance and were successfully treated with Fansidar, tetracycline and quinine. Two cases were grade II resistance and presented clinically as cerebral malaria. Intravenous quinine was given plus Fansidar and tetracycline. The cases were resolved without sequele or recurrence. None of the cases, except for 2, received chemoprophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Imported case of malaria in Taiwan: analysis of 11 cases]. 167 9

A preterm infant with possible congenital clinical malaria is described. The infant developed persistent pyrexia, hyperbilirubinaemia, anaemia, increasing gastric residuals and hepatosplenomegaly from the 7th day of life. Thick and thin smears of the infant's blood were heavily loaded with various asexual stages of Plasmodium falciparum. The parasite exhibited R1 resistance. There was no satisfactory response to chloroquine, but response to intravenous quinine therapy was achieved on day 15. The initial 6-month follow-up period was uneventful. The mother had apparently had chloroquine-resistant malaria which responded to sulfadoxine-pyrimethamine (Fansidar).
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PMID:Congenital malaria with chloroquine resistance. 171 26

Some 200 cases of malaria are officially reported yearly in Switzerland. It is estimated that 2000-8000 Swiss travellers are infected by the anopheles mosquito annually, with 90% protected by chemoprophylaxis. An attack of malaria appears to have a better prognosis when the symptoms start in Africa, since treatment is initiated immediately, than in industrialized countries where the mortality is 1-4%. Failure to inquire into travel history is often responsible for the delay in initiating treatment. Severe falciparum malaria is treated by repeated slow quinine infusions followed by 1500 mg sulfadoxine, 75 mg pyrimethamine and 750 mg mefloquine (single dose). This adult dose corresponds to 3 tablets of Lariam and 3 of Fansidar (or 3 of Fansimef). The increase in chloroquine resistance among falciparum strains has led to the use of Fansidar for chemoprophylaxis, followed by the use of mefloquine when Fansidar resistance occurs. The dosage of mefloquine is 250 mg weekly (1 tablet Lariam) for 4 weeks, followed by 1 tablet every fortnight. Treatment is continued for 1 month after return. If the risk of transmission is low, chemoprophylaxis may be replaced by prescription of a reserve drug to be taken in case of fever and headache. A sulfadoxine-pyrimethamine-mefloquine combination (i.e. 3 tablets Fansimef) has been tested in this indication. Ineffective chemoprophylaxis may lead to atypical clinical syndromes, e.g. anemia, hepatosplenomegaly and jaundice, without episodes of fever. HIV positive subjects may risk travelling in tropical countries if they have undergone correct chemoprophylaxis.
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PMID:[Malaria in Switzerland]. 306 91

Of 4651 admissions between February 1995 and February 1996, 1043 had a presumed diagnosis of malaria. Six hundred and twenty-seven cases were confirmed by thick blood film examinations. The highest prevalence was in October (124/480 admissions) and the lowest in March (12/303). Sixty-five children died while 562 survived, 12 with defects. The first treatment in 422 children was chloroquine, in 143 quinine, in 59 halofantrin, and in three pyrimethamine with sulfadoxine (Fansidar). 23/422 patients started on chloroquine were switched to halofantrine, two to quinine. A higher mortality was associated with coma, convulsions, hepatosplenomegaly, pulmonary congestion, jaundice, haemoglobinuria, bladder paralysis, anuria. Anaemia and fever were more severe and hypoglycaemia more frequent in children who died than in children who survived (packed cell volume 18.5 +/- 7.1 per cent vs. 25.6 +/- 7.6 per cent, p < 0.001; temperature 39 +/- 1.1 degrees C vs. 38.7 +/- 0.9 degrees C, p < 0.05; random blood sugar < 40 mg/100 ml; 76 vs. 22 per cent, p < 0.01). There was no difference in the median age, pretreatment duration, and prevalence of diarrhoea and sickle cell disease. The male to female ratio was 1.5:1 in the surviving children vs. 1:1.03 in the dead.
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PMID:Malaria prevalence and outcome in the in-patients of the Paediatric Department of the State Specialists Hospital (SSH), Maiduguri, Nigeria. 960 1

During a five year period, 233 cases of malaria (2.4%) were diagnosed among 9259 children with fever and hepatosplenomegaly seen in Asir Central Hospital, Abha, Saudi Arabia. The majority of these were below four years of age and came from Tihama, a hot, humid valley area in the Asir region. The infection was seasonal and occurred between December and May. Apart from fever, vomiting and hepatosplenomegaly, anemia was a common clinical finding; this was partly due to iron deficiency anemia, probably nutritional. Most of the cases responded to chloroquine therapy; however, three required intravenous quinine and two received Fansidar to effect eradication of the parasitemia. During the study, two patients died, one from cerebral malaria and the other from severe hemolytic anemia and hemoglobinuria. For prevention of malaria in this endemic area, an integrated program is advocated that includes the use of bednets impregnated with permethin, adequate treatment of proven cases and intensive health education on malaria control and nutrition.
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PMID:Malaria in children - experience from Asir region, Saudi Arabia. 1758 50