Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia
A 63-year-old Caucasian woman developed severe Plasmodium falciparum malaria when travelling back from Cameroun. No antimalarial chemoprophylaxis had been observed. The patient was immediately admitted to the intensive care unit after evidence of multiple organ failure (coma, shock, acute respirator...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/696725 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832556759775969280 |
|---|---|
| author | Emeline Masse Philippe Hantson |
| author_facet | Emeline Masse Philippe Hantson |
| author_sort | Emeline Masse |
| collection | DOAJ |
| description | A 63-year-old Caucasian woman developed severe Plasmodium falciparum malaria when travelling back from Cameroun. No antimalarial chemoprophylaxis had been observed. The patient was immediately admitted to the intensive care unit after evidence of multiple organ failure (coma, shock, acute respiratory distress syndrome, acute renal failure, etc.). However, initial parasitemia was less than 1%. The patient was managed by intravenous quinine and norepinephrine infusion due to refractory shock. The patient developed as an early complication ischemic lesions of both arms and feet. In addition to laboratory changes consistent with disseminated intravascular coagulation, there was also evidence for a low activity of the von Willebrand factor (VWF) cleaving protease ADAMTS13. Later complications included repeated candidemia and bacteraemia despite appropriate therapy; the origin appeared to be diffuse ischemic injury of the gastrointestinal tract. The patient ultimately recovered, but quadriamputation was necessary to treat symmetrical peripheral gangrene (SPG). In severe Plasmodium falciparum malaria, ischemic changes may be due to microvascular obstruction, but, in patients with low parasitemia, other endothelial factors may also be involved as observed in other groups of thrombotic microangiopathies. |
| format | Article |
| id | doaj-art-9099ca509f584d9a8dc3c7354df44c84 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-9099ca509f584d9a8dc3c7354df44c842025-02-03T05:44:30ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/696725696725Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and BacteraemiaEmeline Masse0Philippe Hantson1Département des Soins Intensifs, Université Catholique de Louvain, Cliniques Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, BelgiumDépartement des Soins Intensifs, Université Catholique de Louvain, Cliniques Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, BelgiumA 63-year-old Caucasian woman developed severe Plasmodium falciparum malaria when travelling back from Cameroun. No antimalarial chemoprophylaxis had been observed. The patient was immediately admitted to the intensive care unit after evidence of multiple organ failure (coma, shock, acute respiratory distress syndrome, acute renal failure, etc.). However, initial parasitemia was less than 1%. The patient was managed by intravenous quinine and norepinephrine infusion due to refractory shock. The patient developed as an early complication ischemic lesions of both arms and feet. In addition to laboratory changes consistent with disseminated intravascular coagulation, there was also evidence for a low activity of the von Willebrand factor (VWF) cleaving protease ADAMTS13. Later complications included repeated candidemia and bacteraemia despite appropriate therapy; the origin appeared to be diffuse ischemic injury of the gastrointestinal tract. The patient ultimately recovered, but quadriamputation was necessary to treat symmetrical peripheral gangrene (SPG). In severe Plasmodium falciparum malaria, ischemic changes may be due to microvascular obstruction, but, in patients with low parasitemia, other endothelial factors may also be involved as observed in other groups of thrombotic microangiopathies.http://dx.doi.org/10.1155/2014/696725 |
| spellingShingle | Emeline Masse Philippe Hantson Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia Case Reports in Medicine |
| title | Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia |
| title_full | Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia |
| title_fullStr | Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia |
| title_full_unstemmed | Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia |
| title_short | Plasmodium falciparum Malaria Complicated by Symmetrical Peripheral Gangrene, Bowel Ischemia, Repeated Candidemia, and Bacteraemia |
| title_sort | plasmodium falciparum malaria complicated by symmetrical peripheral gangrene bowel ischemia repeated candidemia and bacteraemia |
| url | http://dx.doi.org/10.1155/2014/696725 |
| work_keys_str_mv | AT emelinemasse plasmodiumfalciparummalariacomplicatedbysymmetricalperipheralgangrenebowelischemiarepeatedcandidemiaandbacteraemia AT philippehantson plasmodiumfalciparummalariacomplicatedbysymmetricalperipheralgangrenebowelischemiarepeatedcandidemiaandbacteraemia |