Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rickettsia africae was identified in seven (6%) of 118 patients with acute fevers of unknown etiology proven not to be malaria or typhoid fever from clinics along the coastal region of Cameroon by polymerase chain reaction (PCR) amplification and sequencing of the citrate synthase (gltA) and outer membrane protein A (ompA) genes of Rickettsia. The majority (71%) of the patients were female. Clinical manifestations included fever (100%), headache (71%), myalgia (71%), arthralgia (43%), pulmonary involvement (29%), and diffuse rash (14%). Moreover, R. africae was detected by PCR amplification and sequence analysis of the gltA and ompA genes in 62 (75%) of 83 adult Amblyomma variegatum ticks collected from cattle in the same region. These results confirm the presence of a previously unrecognized infectious disease in the indigenous Cameroonian population, as well as extend the established range of R. africae.
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PMID:Detection of Rickettsia africae in patients and ticks along the coastal region of Cameroon. 1538 20

To explore the relationship between the ingestion of Agouti paca (AP) and human leptospirosis in Guyana, 19 febrile men who said they had hunted and eaten A. paca were screened for malaria, using bloodsmears, and for leptospirosis, using an enzyme immuno-assay that detects Leptospira -specific IgM. Those found positive for anti-Leptospira IgM were then evaluated further, with a microscopical agglutination test based on a limited panel of serovars from three pathogenic species of Leptospira. Although six of the 18 patients who provided suitable samples for the serology were found seropositive for acute leptospirosis, only three of the 19 patients were found smear-positive for malaria. A clinical-decision model, based on medical histories, the results of physical examinations, and the use of routine urine dipsticks, and enabling prediction of the serological results, was developed. This model, which had 83% sensitivity and 100% specificity for leptospirosis, indicated that, in the absence of serology, most febrile patients reporting AP ingestion could be correctly treated if each was checked for malaria using traditional bloodsmears. The smear-positives should be treated with antimalarial drugs whereas the smear-negatives should be treated for leptospirosis if they had any of the following: a skin rash; lymphadenopathy; abnormal urine sediment (proteinuria or haematuria); and/or no previous history of malaria. In the present study, the relative risk of leptospirosis among the patients who were smear-negative for malaria and fulfilled at least one of these four criteria was 13 (P = 0.0007). In Guyana at least, leptospirosis appears to be common among men who hunt, prepare and ingest AP. Vaccines may be the best, practical form of protection among such men.
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PMID:Leptospirosis in febrile men ingesting Agouti paca in South America. 1566 17

Haematological changes are common in malaria. Thrombocytopenia is a common finding in falciparum infection but rare in Plasmodium vivax. We report a case of 7-year-old male patient presenting with fever, petechial rash, and platelet counts of 6 x 10(9)/l due to Plasmodium vivax malaria.
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PMID:Plasmodium vivax malaria presenting with severe thrombocytopenia. 1584 68

To assist the Peruvian Ministry of Health in modifying the malaria treatment policy for their north Pacific coastal region, we conducted an in vivo efficacy trial of sulfadoxine-pyrimethamine (SP) and SP plus artesunate (SP-AS) for the treatment for uncomplicated Plasmodium falciparum infections. A total of 197 patients were randomized to therapy with either SP (25 mg/kg of the sulfadoxine component in a single dose on day 0) or a combination of SP plus AS (4 mg/kg on days 0, 1, and 2) and were followed for 28 days for symptoms and recurrence of parasitemia. No statistically significant differences between the two groups were observed on enrollment with respect to age, sex, history of malaria, or geometric mean parasite density. A total of 185 subjects completed the 28-day follow-up. Of the 91 subjects treated with SP alone, two had recurrences of parasitemia on day 7 and one on day 21. Of the 94 subjects treated with SP-AS, one had a recurrence of parasitemia on day 21. Fever and asexual parasite density decreased significantly more rapidly and the proportion of patients with gametocytemia on days 3-28 was significantly lower in subjects treated with combination therapy than in those who received SP alone. No severe adverse drug reactions were observed; however, self-limited rash and pruritus were significantly more common and an exacerbation of nausea, vomiting, and abdominal pain were observed significantly more frequently among patients who had received SP-AS. These results have contributed to a National Malaria Control Program decision to change to SP-AS combination therapy as the first-line treatment for uncomplicated P. falciparum malaria in northern coastal Peru in November 2001, making Peru the first country in the Americas to recommend this combination therapy.
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PMID:Efficacy and tolerability of artesunate plus sulfadoxine-pyrimethamine and sulfadoxine-pyrimethamine alone for the treatment of uncomplicated Plasmodium falciparum malaria in Peru. 1589 Nov 31

Fever occurring during or after a period of time spent in a tropical area is an important element for both patient and the doctor attending him and having to cope with a varied differential diagnosis. First of all, it should be appreciated whether or not the case is an emergency, the admittance in the hospital being compulsory, or the case can be investigated in ambulatory. The differentiation between a "tropical fever" and a common one should be rapidly done, as certain tropical diseases have to be notified and isolation of the patient, identification of the new cases and contacts are recommended. A very carefully anamnesis, in order to define the place, period of time, the purpose of the travel, the specific chemoprophylactic measures, if other travellers have the same complaints should be done and a very good knowledge on the geography of parasitic and infectious diseases is required. Fever can be either acute or chronic. The clinical signs and symptoms accompanying the fever (rash, conjunctival chemosis, haemorrhages, flu like syndrome, jaundice, pulmonary signs, diarrhoea, hepatosplenomegaly, lymphadenopathy), will be considered in a context of a thorough differential diagnosis. The first choice laboratory investigations have to be completed with the specific ones and the quality of the laboratory, mainly in parasitology is essential. The first attitude, when the suspicion of tropical fever occurs, is to perform a systematic evaluation for malaria diagnosis. Travel medicine advice becomes indispensable and, if it is performed by a qualified person, it is very efficient. The recommendations have to take into account the purpose of the travel, the age, immune status and associated pathology of the subject, being adapted and personalized.
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PMID:[Significance of fever following a trip to a tropical region]. 1675 48

Chikungunya fever is a viral disease transmitted to humans by the bite of infected Aedes aegypti mosquito. Like malaria and dengue, this infection has almost become endemic in India, especially central and south India. Symptoms of sudden onset of fever, chills, headache, nausea, vomiting, joint pain with or without swelling, low back pain, and rash are very similar to those of dengue but, unlike dengue, there is no hemorrhagic or shock syndrome form. Chikungunya is a self-limiting illness with no specific treatment. Travellers visiting endemic areas should be careful and take precautions to see that they are not bitten by mosquitoes.
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PMID:Chikungunya. 1725 33

Differential diagnosis of fever in travelers returning from the tropics is extremely diverse. Apart from the travel destination, other diagnostic predictors of tropical infections are poorly documented in returning travelers. From April 2000 to December 2005, we prospectively enrolled all patients presenting at our referral centers with fever within 1 year after visiting a tropical or subtropical area. For clinical relevance, the diagnostic predictors of the leading tropical conditions were particularly investigated in the febrile episodes occurring during travel or within 1 month after return (defined as early-onset fever). In total, 2071 fever episodes were included, occurring in 1962 patients. Most patients were western travelers (60%) or expatriates (15%). Regions of exposure were mainly sub-Saharan Africa (68%) and southern Asia/Pacific (14%). Early-onset fever accounted for 1619 episodes (78%). Most tropical infections were related to specific travel destinations. Malaria (mainly Plasmodium falciparum) was strongly predicted by the following features: enlarged spleen, thrombocytopenia (platelet count <150 x 10(3)/microL), fever without localizing symptoms, and hyperbilirubinemia (total bilirubin level >or=1.3 mg/dL). When malaria had been ruled out, main predictors were skin rash and skin ulcer for rickettsial infection (mainly African tick bite fever); skin rash, thrombocytopenia, and leukopenia (leukocyte count <4 x 10(3)/microL) for dengue; eosinophil count >or=0.5 x 10(3)/microL for acute schistosomiasis; and enlarged spleen and elevated alanine aminotransferase level (>or=70 IU/L) for enteric fever. The initial clinical and laboratory assessment can help in selecting appropriate investigations and empiric treatments for patients with imported fever.
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PMID:Fever after a stay in the tropics: diagnostic predictors of the leading tropical conditions. 1722 Jul 52

Artemisinin-based combination therapy (ACT) is increasingly being adopted as the first-line treatment for malaria in sub-Saharan Africa. In September-November 2005, in New Halfa, eastern Sudan, the efficacy of artesunate-sulfadoxine-pyrimethamine (AS-SP) for the treatment of uncomplicated, Plasmodium falciparum was compared with that of artesunate-amodiaquine (AS-AQ). The artesunate was given at 4 mg/kg. day on days 0-2, with either a single dose of SP (25 mg sulfadoxine/kg) given on day 0, or AQ, at 10 mg/kg. day, given on days 0-2. Eighty-two of the patients treated (40 given AS-SP and 42 given AS-AQ) completed the 28 days of follow-up. On day 3 all the patients were afebrile and only one patient, in the AS-AQ group, was still parasitaemic. AS-SP appeared slightly more efficacious than AS-AQ but the differences were not statistically significant. Only one patient (2.5%) given AS-SP but four (9.5%) of those given AS-AQ were initially considered to be late treatment and parasitological failures, with all other patients showing an adequate treatment response. The PCR-corrected frequencies of cure were 97.5% for AS-SP and 95.2% for AS-AQ (P>0.05). No gametocytaemias were observed during the follow-up and, although mild adverse effects (nausea, vomiting, abdominal pain, dizziness and/or rash) were detected in 14 patients, they occurred at the same frequency in each treatment arm. It therefore appears that the AS-SP and AS-AQ combinations were both effective and safe for the treatment of uncomplicated, P. falciparum malaria in eastern Sudan.
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PMID:Efficacies of artesunate plus either sulfadoxine-pyrimethamine or amodiaquine, for the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan. 1724 6

Renal failure and uremic encephalopathy are rare findings in Plasmodium vivax malaria. Thrombocytopenia is also an unusual manifestation of P. vivax malaria. This report highlights the occurrence of these rare manifestations in an 8-year-old boy who presented to us with fever, rash and progressive deterioration of renal functions.
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PMID:Unusual presentation of Plasmodium vivax malaria with severe thrombocytopenia and acute renal failure. 1726 56

Rash is not generally believed to be a symptom of malaria. Two cases of acute falciparum malaria in non-immune residents of Mozambique who presented with pruritic rashes are reported. One case exhibited classical urticaria, the other a pruritic papular rash. Review of the literature reveals cases of malaria from India, East Africa, France, and the USA presenting with urticaria or a pruritic rash. Previous exposure to malaria may be a factor in these presentations. Physicians should not discount the diagnosis of malaria in patients with a history of exposure if they present with a rash. This may be of particular importance in travellers returned from malarious areas to developed countries.
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PMID:Falciparum malaria presenting with pruritic rashes. 1729 80


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