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Titolo:
Severe falciparum malaria
Autore:
Lamparter, S; Schoner, K; Moll, R; Mennel, HD; Maisch, B;
Indirizzi:
Univ Marburg, Innere Med Klin SP Kardiol, D-35033 Marburg, Germany Univ Marburg Marburg Germany D-35033 P Kardiol, D-35033 Marburg, Germany Univ Marburg, Abt Pathol, D-35033 Marburg, Germany Univ Marburg Marburg Germany D-35033 bt Pathol, D-35033 Marburg, Germany Univ Marburg, Abt Neuropathol, D-35033 Marburg, Germany Univ Marburg Marburg Germany D-35033 uropathol, D-35033 Marburg, Germany
Titolo Testata:
DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT
fascicolo: 4, volume: 126, anno: 2001,
pagine: 76 - 78
Fonte:
ISI
Lingua:
GER
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
8
Recensione:
Indirizzi per estratti:
Indirizzo: Lamparter, S Univ Marburg, Innere Med Klin SP Kardiol, Baldingerstr, D-35033 Marburg, Germany Univ Marburg Baldingerstr Marburg Germany D-35033 g, Germany
Citazione:
S. Lamparter et al., "Severe falciparum malaria", DEUT MED WO, 126(4), 2001, pp. 76-78

Abstract

History and admission findings: A 57-year-old white man had been travelling in Kenya for vacation until 14 days before admission. Due to apprehensionabout side effects, the patient had refused any malaria prophylaxis. Ten days before admission he developed low grade temperatures and suffered from pain in the limbs, from nausea and vomiting. A new episode of tachyarrhythmia was diagnosed two days before admission and was treated by his general practitioner. Finally he was admitted to our hospital because of high temperatures, chills and progressive clinical deterioration. Autopsy revealed prominent congestion of liver, spleen and cerebral vessels as well as subduraland subarachnoidal hemorrhage. Investigations: In both thin and thick peripheral blood smears Plasmodium parasites were demonstrated in approximately 30% of the eryhthrocytes and the diagnosis of Plasmodium falciparum was immediately confirmed by an immunological test. Treatment and course: Due to the fulminant clinical and neurological deterioration with progressive hypoxaemia, the patient required ventilator therapy already one hour after admission. Therapy with chinine and doxycycline was initiated and exchange transfusion was considered. However, due to hyperkalaemia and cardiac arrest, the patient died 4 hours after admission due to parasitic hemolysis. Conclusions: Severe Plasmodium falciparum infection in nonimmunized patients is a medical emergency and requires immediate diagnosis and treatment. Malaria should always be considered in the differential diagnosis in personswho have travelled to endemic areas and presenting not only with temperatures, but also with non-specific clinical signs, like cardiac arrhythmias. Although never entirely effective, chemoprophylaxis is highly recommended.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/09/20 alle ore 22:37:35