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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Even in endemic zones, congenital malaria, first described in 1876, is rarely encountered. The incidence has greatly increased however over the last 10 years suggesting several diagnostic problems. We observed a case of infected twins born to an asymptomatic mother which would throw some light on the pathophysiology involved in congenital transmission. A 2-month old infant was hospitalized for surgical cure of an umbilical hernia. Haemolytic anaemia (6.3 g/dl) and fever (39 degrees C) were observed during the postoperative period. A wide spectrum antibiotherapy was prescribed but the temperature remained at 39 degrees C. A blood swab cultured one week after the operation revealed Plasmodium falciparum. The infant's twin sister was in apparently good health but was also found to be anaemic (6.1 mg/dl Hg) and a blood sample was positive for P. falciparum. For the mother, the search for parasites was negative. Serology tests performed at diagnosis revealed anti-P. falciparum antibodies at 1/1600, 1/3200 and 1/6400 in the infant, his twin sister and the mother. Outcome was favourable. The mother had arrived in France from Togo 14 months earlier and had not returned to an endemic zone. She had had frequent episodes of fever in Togo and had taken quinine, but no episode of fever had occurred during the pregnancy or delivery. This twin case of vertical mother-infant transmission is the equivalent to transfusional malaria since red cells pass the placental barrier near the end of pregnancy, even when no placental lesion exists. Congenital transfusional malaria must however be dissociated from congenital infective malaria resulting from early primoinfection in endemic areas.
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PMID:[Congenital malaria. A case observed in twins born to an asymptomatic mother]. 807 37

The author worked for almost two years in a remote little clinic in Chesta, West Kenya. It was common for a child to be brought to the clinic with high temperature and other symptoms and be treated for cerebral malaria, lung inflammation, or meningitis. These episodes occurred day and night, sometimes the children were saved and sometimes they died. The author arrived in Kenya on her fourth missionary assignment looking for work and acceptance as a registered nurse. Six weeks had to be spent at a polyclinic and 12 weeks at various children's wards with Kenyan hospitals. There was a lack of medicines and supplies and an enormous turnover of patients. The organization that she was associated with had problems in finding replacements in health work in West Kenya, where, in connection with the usual evangelical work, clinics had been in operation for 12 years. She was requested by NORAD to participate in the health care component of an integrated development program at the Chesta mission station in West Pokot. The work involved being on duty in the clinic as well as out in the field, driving around and even flying on the mission's helicopter to reach villages in the Cherangani Hills. There were mobile clinics at 6 sites in the mountains with 1 visit per month. At 2 of these sites there was an integrated development program comprising health, agriculture, school development, and evangelization. The World Health Organization's vaccination program was conducted at every site. The available services included a maternal-child health care clinic, family planning, teaching of local midwives, and treatment of the sick. The Christian principle of placing equal value on all people was the foundation of the work. This was especially important for women: to be considered not just as chattel of men but as work partners with their own identities and worth.
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PMID:[Nursing under a different sky: West Kenya]. 827 35

A 32-year-old woman in the 26th week of pregnancy became ill, 6 days after returning from a trip to Indonesia, with a fever up to 42 degrees C, haemolytic anaemia (haemoglobin 7.6 g/dl) and thrombocytopenia (7,000/microliters). She had not been on any malaria prophylaxis. Chloroquine, quinine and pyrimethamine, administered after macrogametocytes of Plasmodium falciparum had been found in the blood smear, eliminated the parasites from the peripheral blood, but respiratory failure and treatment-resistant pneumonia occurred, leading to the adult respiratory distress syndrome (Morel stage 4). Because of threatened intrauterine death (resulting from premature placental separation during artificial ventilation) the child was delivered by an emergency section. Despite extensive conventional therapeutic measures the mother's respiratory state progressively deteriorated so that extracorporeal membrane CO2 elimination was instituted on the 17th day. First signs of improvement in respiratory functions were noted after six days. The extracorporeal CO2 elimination was discontinued after twelve days, because artificial ventilation could now be adequately controlled. The woman was gradually weaned from the ventilator and discharged home without symptoms after a total of 11 weeks in hospital. Her child has not shown any neurological symptoms.
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PMID:[Acute respiratory failure in tropical malaria during pregnancy. Successful treatment using extracorporeal CO2 elimination]. 818 19

A 24-year-old woman was infected with falciparum malaria during travel to Kenya, complicated by intravascular coagulation and pulmonary edema. She was successfully treated with anti-malarial drugs including chloroquine, quinine sulfate and pyrimethamine, with a combined regimen of heparin, antithrombin III and nafamostat mesilate for disseminated intravascular coagulation, and with methylprednisolone pulse therapy for pulmonary edema. The present case emphasizes the importance of early diagnosis and appropriate treatment in terms of falciparum malaria. This case, in particular, is believed to be worth reporting as overseas travel is increasing and yet anti-malarial drugs are not readily available to most physicians in Japan.
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PMID:Falciparum malaria in an overseas traveler complicated by disseminated intravascular coagulation and pulmonary edema. 840 May 1

A 27-year old female from Nairobi was admitted to the medical wards of the Kenyatta National Hospital in May 1991. She presented with a 4-week history of productive cough, fever, weight loss, and night sweats. She acknowledged a history of contact with a patient known to have pulmonary tuberculosis. She has never received a blood transfusion. She was single and para 3 + 0. Examination revealed a sick patient, with moderate pallor, fever of 38 degrees Celsius, and who was wasted with moderate dehydration and oral thrush. There was no finger clubbing, lymphadenopathy, or pedal edema. Chest examination revealed bilateral basal pneumonia. The spleen was palpable 4 cm below the costal margin; the liver was not enlarged. The rest of the examination was normal. On admission, complete blood count showed a haemoglobin of 5.4 g/dl, total white cells were 12.5 x 10-9/L, with 82% polymorphonuclear cells and 18% lymphocytes, erythrocyte sedimentation rate (ESR) was 85 mm/hour, and platelet count was normal. The anemia was normocytic, normochromic, and no malaria parasites were seen. Urea and electrolytes and liver function tests were normal. Sputum showed no acid fast bacilli on Ziel-Neelson Stain. HIV-1 antibodies were positive by enzyme-linked immunosorbent assay (ELISA) and Western blot. Bone marrow aspirate revealed a hypercellular marrow with reversed M:E ration, dyserythropoesis, reticulum cell hyperplasia, plentiful golden yellow pigment, and clumps of Histoplasma capsulatum. Chest X-ray showed bilateral basal pneumonia. She was treated with antibiotics and intravenous fluids, but she remained febrile, her general condition progressively deteriorated, and she died a week after admission. Treatment for histoplasmosis had not been commenced, and no postmortem examination was carried out.
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PMID:Disseminated histoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS): a case report. 851 33

A 44-year-old Spanish woman travelled in Kenya without doing correct malarial prophylaxis. Upon her return to Spain, she suffered from Plasmodium falciparum malaria. She was initially treated with chloroquine for three days, but her state worsened and she was admitted to our intensive care unit. On admission, parasitaemia was 22%. She had hyperpyrexia, obtundation, hypotension, tachycardia, tachypnoea, jaundice, digestive haemorrhage, petechiae in her soles, oliguria with elevation of serum uraemia and creatinine, anaemia, thrombocytopaenia, hypoproteinaemia, hyponatraemia, hypocalcaemia, metabolic acidosis and parameters of disseminated intravascular coagulation. She was given quinine, sulfadoxine-pyrimethamine and clindamycin. An exchange transfusion was performed, during which an acute pulmonary oedema appeared, initially with high pulmonary artery wedge pressure. She required mechanical ventilation for 16 days and haemodialysis for 11 days. She remained in coma and had seizures which required diazepam, phenitoin and thiopentone. She received a total amount of 22 units of packed erythrocytes, 55 of platelets and 15 of plasma. After the first week, she had nosocomial infection due to Escherichia coli, Staphylococcus and Pseudomonas aeruginosa and was treated with the corresponding antibiotics. She cured completely. This case report gives us the possibility of discussing on frequent problems in the prevention and treatment of malaria, and on the treatment of severe, life-threatening malaria in the setting of the intensive care unit.
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PMID:[Multiple organ failure in Plasmodium falciparum malaria]. 853 25

Epstein-Barr virus (EBV) has been linked to several undifferentiated carcinomas of the aerodigestive tract, especially the nasopharynx, but has not been reported in the biliary tract. We here presented a case of an unusual cholangiocarcinoma harboring EBV genome in a 47-year-old Chinese woman. Physical examination in 1988 in Taiwan, including abdominal sonography of the liver, was essentially negative. She experienced three episodes of malaria in 1990 when she worked in Ghana, Africa, and felt a tumor mass in the epigastrium in October 1992. She received an extended left lobectomy for a huge hepatic tumor of 12 x 10 x 5.5 cm in February 1993. Light microscopy revealed a cholangiocarcinoma composed of both well-differentiated adenocarcinoma and lymphoepitheliomatous undifferentiated carcinoma components. Abundant EBV EBER1 was shown in both tumor components, but not in the nontumor liver. Southern blot analysis and polymerase chain reaction showed a monoclonal episomal form of EBV, with a genotype characteristic for Chinese EBV strain type 1. This finding suggests that the EBV infection preceded monoclonal EBV-harboring tumor cell expansion in this case.
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PMID:Clonal Epstein-Barr virus associated cholangiocarcinoma with lymphoepithelioma-like component. 876 21

A 28-year-old woman developed puerperal endomyometritis and tertian malaria simultaneously. She delivered her child by vacuum extraction during week 41 of pregnancy in September 1994. The peripartal period was uneventful. Nine days post partum the patient was readmitted to hospital with fever and pain in the area of the episiotomy. On day 13 post partum a hysterectomy was performed because of suspected abscess-forming endomyometritis. Two days after the hysterectomy the patient developed septic temperatures, which persisted for 10 days. Tertian malaria due to Plasmodium vivax was found to be the cause of fever. The patient had been in Indonesia without anti-malarial prophylaxis in 1991. Two years later she travelled to Ghana, having taken mefloquine as prophylaxis. Malaria was obviously caused by reactivated hypnozoites in the liver, although the patient had never had an episode of fever associated with malaria before. This case proves that tertian malaria may "recur" even without previous manifestation, years after a stay in a region endemic for malaria.
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PMID:Postpartal endomyometritis in a case of unknown tertian malaria. 918 89

You may have been wondering why there have been no further installments of African Diary. The short answer is that Diana was very ill from the side-effects of anti-malaria drugs. She has been back in this country being treated and having a spell of rest and recuperation. You will remember that Diana and Colin, her husband, had left Mozambique and were very busy building up a new mission station, funded by a business man from Liverpool, in Uganda. Before being taken ill, Diana had written some notes for the Journal which will be enough for two more articles. Diana and Colin have not yet decided whether they will return to Africa but we have told Diana how Journal readers enjoyed reading her news. We wish her well for the future.
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PMID:African diary. 928 30

We report the case of a pregnant woman (29th week), living in a Paris suburb, about 20 miles from an international airport. She presented with septic shock and severe acute respiratory distress syndrome (ARDS). A few parasitized erythrocytes were discovered in a hemorrhagic bronchoalveolar lavage (BAL), specimen and many were found on examination of the placenta after a caesarean section had been performed. The patient's condition dramatically improved once given quinine therapy. This is an uncommon case on account of: (1) the unusual clinical course with no organ failure but ARDS, (2) the unusual way the diagnosis was made, (3) the very unusual way the patient became contaminated (airport malaria), (4) the pregnant condition of the patient.
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PMID:Acute respiratory distress syndrome due to falciparum malaria in a pregnant woman. 929 Sep 95


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