Fatal Cerebral Malaria with Multi-Organ Dysfunction and Oleander Poisoning

2017 ◽  
Vol 06 (01) ◽  
Author(s):  
Akshaya K Mohanty ◽  
Praveen K Sahu ◽  
Pattnaik R ◽  
Anita M ◽  
Kishore C Mahanta ◽  
...  
2021 ◽  
Vol 50 (1) ◽  
pp. 24-24
Author(s):  
Hunter Johnson ◽  
Madiha Raees ◽  
Evangelina Urbina ◽  
Terrie Taylor ◽  
Karl Seydel ◽  
...  

2021 ◽  
pp. cc-75
Author(s):  
Manoj Kumar Mohapatra ◽  
Shraddha Laxmidhar Mohanty ◽  
Prafulla Kumar Bariha ◽  
Khetra Mohan Tudu ◽  
Abhipsa Mohapatra ◽  
...  

Introduction: The underlying mechanism of cerebral malaria alone or with multiple organ dysfunction (MOD) among patients with falciparum malaria is not clearly understood. Though autopsy studies showed various types of pathological changes, during life Magnetic Resonance Imaging (MRI) can identify structural and functional modication of brain during the disease process. There have been few MRI studies of brain among adult patients with cerebral malaria (CM) but none with CM and MOD. Therefore, we have conducted this study to nd out and to compare the MRI abnormalities among patients of CM and CM with MOD. Methods: This prospective study has been conducted at VSSIMSAR, Burla in which 138 consecutive patients of severe falciparum malaria were enrolled. 119 patients after exclusion were subjected to MRI within 10 hours of admission and it was repeated as per the protocol. The diagnosis of P.falciparum malaria was done by peripheral smear or Rapid diagnostic test. The diagnosis of sever malaria was done by WHO criteria. Patients of CM were grouped into Group-1 and of CM with MOD to Group-2. Results: In the study CM and CM with MOD constituted 29 (24.4%) and 90 (75.6%) patients. MRI showed increased brain volume, vasogenic oedema, and cortical thickening in all patients of severe malaria. Cytotoxic oedema also found in 37.9% of cases of CM and 75.5% of MOD (p<0.001). Infarction and haemorrhage were found in less percentage of cases. Predominant posterior swelling consistent with posterior reversible encephalopathy syndrome (PRES) is found in majority of cases of CM (48.3%) compared to frontal swelling (0.0%) (p<0.001). With treatment MRI ndings improved within 72 hours of treatment. Patients who died did not show any improvement in MRI nding. Conclusion: Different type of MRI ndings at different areas of brain is possible in CM and CM with MOD. It is due to dysfunction of blood brain barrier (BBB) and it can be reversible with treatment. Therefore, intervention with drugs improving BBB may be benecial for survival.


2018 ◽  
Vol 5 (4) ◽  
pp. 954
Author(s):  
Nishanth Dev ◽  
Jhuma Sankar ◽  
B. Lall

Background: Prevalence of complications in malaria continues to grow even with reducing number of malaria cases. Complications associated with malaria can involve multiple organs. There is paucity of literature on factors associated with multi organ dysfunction in different types of malaria.Methods: Our aim was to study the clinical profile of complications in different types of malaria with specific focus on multi-organ dysfunction (MODS). In this cross-sectional study confirmed cases of malaria were enrolled.Results: Plasmodium vivax malaria was the predominant type seen in 74.1% cases. The overall prevalence of thrombocytopenia was 61.5%, hepatic dysfunction 58%, cerebral malaria 16.1%, Hypoglycemia 7.5%, bleeding 34.5%, acute respiratory distress syndrome (ARDS) 5.7% and acute kidney injury (AKI) 49.4%. Hypoglycemia was significantly higher in mixed malaria (0.025, p = 0.025). Hepatic dysfunction and hyperbilirubinemia were significantly higher in mixed malaria (p=0.001). Mortality was seen in mixed malaria (p = 0.007). Only those with mixed malaria died (13%). Patients with MODS had higher prevalence of rashes (p <0.0001) and cerebral malaria (p = 0.000). Serum levels of urea, creatinine, Bilirubin, Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) were significantly higher in patients with MODS (p<0.0001 for all variables). On evaluating factors associated with multi-organ dysfunction presence of cerebral malaria [OR: 6.4 (95% CI): 2.4 to 17.4; p<0.0001], type of malaria (Vivax or Falciparum or both) [1.77 (1.03 to 3.03); p=0.0038], and hypoglycemia [4.4 (1.08 to 17.8); p=0.038] were statistically significant on multivariate analysis.Conclusions: The present study demonstrates the factors associated with multi organ dysfunction and its impact on clinical outcome in different types of malaria.


2003 ◽  
Vol 23 (03) ◽  
pp. 125-130 ◽  
Author(s):  
S. Zeerleder ◽  
R. Zürcher Zenklusen ◽  
C. E. Hack ◽  
W. A. Wuillemin

SummaryWe report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis. The article discusses new therapeutic concepts in the treatment of disseminated intravascular coagulation in meningococcal sepsis, too.


2018 ◽  
Vol 2 (12) ◽  
Author(s):  
Francesco Gazia ◽  
Giacomo De Luca ◽  
Imbalzano Gabriele ◽  
Vincenzo Pellicanò

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