Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chloroquine is considered essentially nontoxic when used for the chemosuppression of malaria, but gastrointestinal upsets, headache, blurring of vision, pruritus, and uritcaria may occur during chloroquine therapy. Recently, Bhargava et al. and Eronini and Eronini have reported the extrapyramidal syndrome (EPS) following chloroquine therapy in adults. The clinical manifestations included upward rolling of the eyeballs, retraction of neck and back, trismus with marked difficulty in speech, and coarse tremors. Observations of 4 instances of EPS in children following chloroquine therapy for malaria are reported. A 2-1/2 year old girl was admitted to the All India Institute of Medical Sciences Hospital with a 4 day history of intermittent high grade pyrexia with chills and rigors. Following treatment with oral chloroquine in the recommended therapeutic dosage, the fever responded, but the child became drowsy and developed paroxysms of involuntary movements of the tongue, torticollis, torsion dystonia of the limbs, and parosysms of tonic muscular spasms. She completely recovered spontaneously within 48 hours. The 2nd case was that of a 12-year old female brought to the hospital with a 15-day history of intermittent high grade fever with chills and rigors. The patient was started on chloroquine sulfate in the recommended therapeutic dose. After an interval of 4 days she developed coarse tremors of the hands, upward rolling of the eyeballs, episodic deviation of the angle of the mouth towards the left, and trismus. These symptoms disappeared spontaneously within 8 hours. A 6-year old girl, the 3rd case, developed episodes of opisthotonous, upward rolling of the eyeballs, protrusions of the tongue, intermittent writhing movements of the upper limbs, and drowsiness following the ingestion of 6 tablets of chloroquine sulfate for suspected diagnosis of malaria. She spontaneously recovered from EPS over a period of about 48 hours. The 4th case, a 7-year old boy, gave a history of high grade fever with chills and rigors of 1 day's duration. He developed drowsiness, tonic spasms of the neck, upward rolling of the eyeballs, and writhing contortions of all limbs about 2 hours following intravenous administration of 100 mg of chloroquine. 8 hours later an additional 100 mg chloroquine was given intravenously for the mistaken diagnosis of cerebral malaria. On examination the child was drowsy, had generalized stiffness, torticollis, and trismus. He recovered gradually over a 48-hour period without any specific therapy. The exact mechanism of production of EPS remains uncertain.
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PMID:Extrapyramidal syndrome following chloroquine therapy. 45 22

The practices of health care workers and the population with regard to diagnosis of malaria and use of antimalarial drugs were studied in the city of Dakar from September 1991 to March 1992. Study included 847 heads of family, 191 treatment prescribers including 77 physicians, 53 nurses and 61 midwives, and 60 pharmacists. Three separate questionnaires were used: one for the population, one for physicians and paramedical staff, and one for pharmacists. The data collected showed that the 4 main symptoms used by both health care workers and the general population for diagnosis of malaria were fever, chills, vomiting, and headache. Treatment was administered upon suspicion of infection by 72% of treatment prescribers. Chloroquine was the drug most widely used by prescribers and for self-treatment of malaria. Prophylactic drug treatment was practised by all groups studied except treatment prescribers but was unappropriate for the target groups. Chloroquine is the drug most widely used to protect against the disease. Pharmacists have adequate supplies but distribution is poor. Despite promising results in the fight against malaria, further effort is needed to train health care workers and provide information to the population.
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PMID:[Health personnel and population practices in the diagnosis of malaria and use of antimalarial drugs in Dakar]. 763 9

Increasing drug resistance in Plasmodium falciparum and a resurgence of malaria in tropical areas have effected a change in treatment of malaria in the last two decades. Symptoms of malaria are fever, chills, headache, and malaise. The prognosis worsens as the parasite counts, counts of mature parasites, and counts of neutrophils containing pigment increase. Treatment depends on severity, age of patient, degree of background immunity, likely pattern of susceptibility to antimalarial drugs, and the cost and availability of drugs. Chloroquine should be used for P. vivax, P. malariae, and P. ovale. P. vivax has shown high resistance to chloroquine in Oceania, however. Primaquine may be needed to treat P. vivax and P. ovale to rid the body of hypnozoites that survive in the liver. Chloroquine can treat P. falciparum infections acquired in North Africa, Central America north of the Panama Canal, Haiti, or the Middle East but not in most of Africa and some parts of Asia and South America. In areas of low grade resistance to chloroquine, amodiaquine can be used to effectively treat falciparum malaria. A combination of sulfadoxine-pyrimethamine is responsive to falciparum infections with high grade resistance to chloroquine. Mefloquine, halofantrine, or quinine with tetracycline can be used to treat multidrug-resistant P. falciparum. Derivatives of artemisinin obtained from qinghao or sweet wormwood developed as pharmaceuticals in China are the most rapidly acting of all antimalarial drugs. Children tend to tolerate antimalarial drugs well. Children who weigh less than 15 kg should not be given mefloquine. Health workers should not prescribe primaquine to pregnant women or newborns due to the risk of hemolysis. Chloroquine, sulfadoxine-pyrimethamine, quinine, and quinidine can be safely given in therapeutic doses throughout pregnancy. Clinical manifestations of severe malaria are hypoglycemia, convulsions, severe anemia, acute renal failure, jaundice, pulmonary edema, cerebral malaria, shock, and acidosis. Health workers should be prepared to treat these symptoms accordingly.
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PMID:The treatment of malaria. 904 53

Morbidity and mortality due to malaria remains an important health problem for travelers visiting endemic zones. In this population, typical episodes of chills and fever followed by diaphoresis are not always observed; inaugural signs may limited to low-grade fever accompanying digestive disorders. Early diagnosis is nevertheless essential to prevent progression to acute pernicious malaria. Blood smears, quantitative butty coat (QBC) test or the Parasight test can give rapid diagnosis. Chloroquine is the drug of choice for Plasmodium vivax, P. ovale or P. Malariae infection, but chloroquine-resistant P. falciparum is widespread in tropical zones and resistant P. vivax has been reported in Indonesia. Currently, halofantrine is the best treatment for P. falciparum infection, although cardiac toxicity may occur in patients with a long QT on the electrocardiogram. Mefloquine can be alternative. The sulfadoxine-pyrimethamine combination is also used in many tropical zones because of its low cost and availability, but many resistant strains of P. falciparum have been identified. Use of quinine is also widespread in tropical zones. This basic antimalarial is rapidly effective but is also rapidly eliminated, necessitating repeated oral doses. Intramuscular injection may provoke necrosis. The main indication for quinine is acute pernicious P. falciparum malaria, but the drug is also used for simple episodes of fever in many tropical zones. Symptomatic care including fluid replacement, oxygen, transfusion, diuretics, respiratory assistance and dialysis may also be required in some cases. Use of corticosteroids or exsanguinotransfusion remains a question of debate. When administered rapidly, fever should regress within a few days. Neurological sequellae are exceptional after acute pernicious malaria in adults but may occur approximately 5% of children, emphasizing the importance of associating chemoprophylaxis and protection against insect bites. There has been much publicity concerning a vaccine, but results to date have been disappointing.
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PMID:[Malaria: what treatment today?]. 909 64

A cross sectional study on the diagnostic and therapeutic practices of health staff and mothers with regard to fever was carried out in the urban area of Brazzaville from the 12th to the 20th of April 1997. 390 children were included in the sample. Children were aged under five years, had suffered from fever 15 days prior to the survey and were treated at home or in a health centre with the most currently used drugs against malaria, results of the questionnaire indicated that those symptoms best recognised by mothers are fever (85.8%), asthenia (79.9%), chills (21.1%), vomiting (25.1%) and diarrhoea (10.9%). Chloroquine is the most used drug at home (66%) and amodiaquine (34.5%) in health centres. Drugs are mainly supplied by private drugstores (67.9%) and street vendors (19.1%). Management of fever requires proper training of health staff and good communication between health personnel and the target population.
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PMID:[Management of child fever in the battle against malaria in Brazzaville]. 1201 65

A cross-sectional study on the diagnostic and therapeutic practices of health staff and mothers with regards to carrying for children's fever was carried out from February 27 to March 16, 1995, in the rural district of Boko. The sample was comprised of 630 children aged less than 5 years old, having suffered from fever within the past 15 days and who were treated either at home or in a local health centre with a drug most presently used against malaria. The results compiled from the responses to the questionnaire have shown that the most frequently cited symptoms by mothers are fever (57.8%), asthenia (51.7%), vomiting (10.6%), chills (7.3%) and diarrhea (7.3%). Chloroquine is the most utilised drug at home (61%) and anti-malaria injections are the most frequently used drugs in health centres (51.7%). The medicine is mainly supplied by public drugstores and pharmacies (47.8%) and street vendors (43.2%). Proper management of a fever requires adequate training of health staff and a good level of communication between health workers and their target populations.
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PMID:[Management of children's fever at home in a rural area of Boko (Congo-Brazzaville)]. 1496 16

This study examined the malaria situation in a malarial endemic area of Nigeria. Structured questionnaire was applied to 300 doctors practising in Enugu urban, Nigeria and confirmation of the clinical diagnosis by laboratory technique was done using 468 patients. The result shows a high prevalence of Plasmodium falciparum infection (96.4% in children, 87.0% in adults). Malaria positivity rate was 51.9% in children and 42.8% in adults. Fever, vomiting and anorexia were the commonest malaria symptoms in children, while headache, fever, chills and rigors were the commonest malaria symptoms in adults. The diagnostic practice of the doctors was clinical. Fever, vomiting and cough were found to be more associated with malaria parasitaemia in children, while in adults fever was found to be more associated with malaria parasitaemia. Chloroquine and sulphadoxine-pyrimethamine were the commonest drugs used for treating uncomplicated malaria, while quinine was the commonest drug used for treating severe malaria.
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PMID:Current clinical presentation of malaria in Enugu, Nigeria. 1562 48

Malaria is a rare but potentially serious complication of blood transfusion. In this report a transfusion-transmitted malaria case has been presented. A 47-years-old woman admitted to our clinic with the complaints of striking fever with chills, diarrhea and vomiting. She had history of an operation and transfusion before 10 days of admission. On physical examination jaundice, splenomegaly and abdominal tenderness were detected. Laboratory results revealed anemia, and elevated LDH and bilirubin levels. Examination of thin blood films yielded Plasmodium vivax trophozoites. Chloroquine was initiated for therapy and the patient was successfully treated. On the other hand, informations about her blood donor indicated that he had been in the military service in Southeast Anatolia of Turkey where malaria is endemic. All the efforts to reach the donor, for his diagnosis and treatment, were failed. Since our region (Northeast Anatolia) is not an endemic area for malaria and the patient had no travel history to an endemic area, it has been considered that the transmission route of malaria in this case was blood transfusion. In conclusion, as there are no available approved tests for malaria screening of donations, the transfusion-transmitted malaria can only be prevented by careful questioning of the donors.
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PMID:[A transfusion-transmitted malaria case]. 1590 Aug 44

A total of 1,885 blood and stool samples of four main protozoan parasitic infections were retrospectively reviewed from January, 2000 to April, 2004. Eleven of the 1,350 stool samples were shown positive for Cryptosporidium and Giardia infections; one of the 5 cases was clinically diagnosed as gastrointestinal cryptosporidiosis, while 6 cases were giardiasis. In patients with giardiasis, children were among the high-risk groups, making up 66.7% of these patients. The common presenting signs and symptoms were: diarrhea (83.3%), loss of appetite (83.3%), lethargy (83.3%), fever (66.7%), nausea/vomiting (50.0%), abdominal pain (16.7%), dehydration (16.7%) and rigor and chills (16.7%). Metronidazole was the drug of choice and was given to all symptomatic patients (83.3%). For the blood samples, 28 of the 92 peripheral smears for Plasmodium spp infection were diagnosed as malaria. The age range was from 4 to 57, with a median of 32.5 years. The sex ratio (M:F) was 3.6:1, while the age group of 30-44 years was the most commonly affected in both sexes. The majority of patients were foreigners (60.7%) and non-professional (39%). Plasmodium vivax (71%) infection was the most common pathogen found in these patients, along with a history of traveling to an endemic area of malaria (31%). The predominant presenting signs and symptoms were: fever (27%), rigor and chills (24%), nausea/vomiting (15%) and headache (8%). Chloroquine and primaquine was the most common anti-malarial regimen used (78.6%) in these patients. The seroprevalence of toxoplasmosis in different groups was 258/443 (58%): seropositive for IgG 143 (32.3%); IgM 67 (15%); and IgG + IgM 48 (10.8%). The age range was from 1 to 85, with a mean of 34 (+/- SD 16.6) years. The predominant age group was 21 to 40 years (126; 28.4%). The sex ratio (M:F) was 1.2:1. Subjects were predominantly male (142; 32%) and the Malay (117; 26.4%). Of these, 32 cases were clinically diagnosed with ocular toxoplasmosis. The range of age was from 10 to 56 years with a mean of 30.5 (+/- SD 12.05) years. The sex ratio (M:F) was 1:1.7. The majority were in the age group of 21 to 40 years, female (20; 62.5%), and Malay (17; 53%). They were also single (16; 50%), unemployed (12; 37%), and resided outside Kuala Lumpur (21; 65.6%). The more common clinical presentations were blurring of vision (25; 78%), floaters (10; 31%) and pain in the eye (7; 22%). We found that funduscopic examination (100%) and seropositivity for anti-Toxoplasma antibodies (93.7%) were the main reasons for investigation. Choroidoretinitis was the most common clinical diagnosis (69%), while clindamycin was the most frequently used antimicrobial in all cases. Among HIV-infected patients, 10 cases were diagnosed as AIDS-related toxoplasmic encephalitis (TE) (9 were active and 1 had relapse TE). In addition, 1 case was confirmed as congenital toxoplasmosis.
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PMID:Parasitic infections in Malaysia: changing and challenges. 1643 80