Vol 57, No 1-4 (2006)
TROPICAL MEDICINE
Submitted: 2013-02-18
Published online: 2010-03-26
Severe malaria – analysis of prognostic symptoms and signs in 169 patients treated in Gdynia in 1991-2005
Jolanta Goljan, Waclaw Leszek Nahorski, Agnieszka Wroczyńska, Iwona Felczak-Korzybska, Halina Pietkiewicz
IMH 2006;57(1-4):149-162.
Vol 57, No 1-4 (2006)
TROPICAL MEDICINE
Submitted: 2013-02-18
Published online: 2010-03-26
Abstract
In the period 1991-2005, 169 patients with the diagnosis of malaria were
hospitalized in the Department of Tropical and Parasitic Diseases, Institute of Maritime
and Tropical Medicine in Gdynia (from 2003 – the Academic Centre of Maritime and
Tropical Medicine, Medical University of Gdansk). All the cases were analysed for
severity, occurrence of complications and permanent sequelae of the disease.According to the criteria set by the WHO (5), malaria was classified as severe in 36
cases. All of them were Plasmodium falciparum infections or mixed infections: P.f. and
another species of the parasite. Patients in this group developed a number of
complications, inter alia shock, acute respiratory distress syndrome (ARDS), acute renal
failure, blackwater fever, severe anemia, disseminated intravascular coagulation,
myocarditis, consciousness disorders of varied degree, acute transient psychoses, and
exacerbation of ischemic heart disease. In one case of a pregnant woman, necrosis of the
fetus occurred in the course of disease in the 4th month of pregnancy. Moreover,
meningoencephalitis was diagnosed in two patients – in one of them concurrently with
symptoms and signs of malaria, while in the other one - 3 weeks after the symptoms
subsided.
In 6 patients, permanent sequelae of the disease developed and in 4 patients the
disease was fatal. The cause of death was multi-organ failure, with the first sign of poor
prognosis being rapidly progressing renal failure resistant to treatment in three men; in
one case death resulted from cerebral malaria.
In cases of suspected malaria, relapsing malaria or in mixed infections, molecular
testing was a valuable complementary tool of diagnosis, which helped in beginning the
appropriate treatment.
Abstract
In the period 1991-2005, 169 patients with the diagnosis of malaria were
hospitalized in the Department of Tropical and Parasitic Diseases, Institute of Maritime
and Tropical Medicine in Gdynia (from 2003 – the Academic Centre of Maritime and
Tropical Medicine, Medical University of Gdansk). All the cases were analysed for
severity, occurrence of complications and permanent sequelae of the disease.According to the criteria set by the WHO (5), malaria was classified as severe in 36
cases. All of them were Plasmodium falciparum infections or mixed infections: P.f. and
another species of the parasite. Patients in this group developed a number of
complications, inter alia shock, acute respiratory distress syndrome (ARDS), acute renal
failure, blackwater fever, severe anemia, disseminated intravascular coagulation,
myocarditis, consciousness disorders of varied degree, acute transient psychoses, and
exacerbation of ischemic heart disease. In one case of a pregnant woman, necrosis of the
fetus occurred in the course of disease in the 4th month of pregnancy. Moreover,
meningoencephalitis was diagnosed in two patients – in one of them concurrently with
symptoms and signs of malaria, while in the other one - 3 weeks after the symptoms
subsided.
In 6 patients, permanent sequelae of the disease developed and in 4 patients the
disease was fatal. The cause of death was multi-organ failure, with the first sign of poor
prognosis being rapidly progressing renal failure resistant to treatment in three men; in
one case death resulted from cerebral malaria.
In cases of suspected malaria, relapsing malaria or in mixed infections, molecular
testing was a valuable complementary tool of diagnosis, which helped in beginning the
appropriate treatment.
Title
Severe malaria – analysis of prognostic symptoms and signs in 169 patients treated in Gdynia in 1991-2005
Journal
International Maritime Health
Issue
Vol 57, No 1-4 (2006)
Pages
149-162
Published online
2010-03-26
Page views
646
Article views/downloads
1148
Bibliographic record
IMH 2006;57(1-4):149-162.
Authors
Jolanta Goljan
Waclaw Leszek Nahorski
Agnieszka Wroczyńska
Iwona Felczak-Korzybska
Halina Pietkiewicz