Verma Anuragani, Singh Anurag, Rawat Shalini, Kushwaha Rashmi
Department of Microbiology, King George Medical University, Lucknow, Uttar Pradesh, India.
Department of Pathology, King George Medical University, Lucknow, Uttar Pradesh, India.
Ann Afr Med. 2024 Oct 23;24(1):194-7. doi: 10.4103/aam.aam_195_23.
Malaria is a severe health issue in India despite government efforts. Malaria has many complications, some of which can be life-threatening. Disseminated intravascular coagulation (DIC) is a prominent malaria complication, besides renal failure, cerebral malaria, pulmonary edema, and anemia. We report a young man with Plasmodium vivax malaria who developed septic shock due to DIC. A 25-year-old male had a fever, abdominal pain, vomiting, and nausea for 5 days. On clinical examination, the patient was in distress and had a fever of 102.6°F with a blood pressure of 86/46 mmHg. A complete blood count revealed anemia, leukocytopenia, and severe thrombocytopenia. Peripheral blood smear findings showed a P. vivax parasite in red blood cells with the presence of a few schistocytes. Further coagulation tests showed raised prothrombin, partial thromboplastin time, and d-dimer. DIC and septic shock required critical care unit admission. Conservative treatment with artesunate and lumefantrine completely cured him. This unusual case shows that P. vivax causes severe malaria and its morbid consequences. It stresses early diagnosis and treatment to prevent mortality and morbidity.
尽管政府采取了措施，但疟疾仍是印度一个严重的健康问题。疟疾有许多并发症，其中一些可能危及生命。除肾衰竭、脑型疟疾、肺水肿和贫血外，弥散性血管内凝血（DIC）是一种突出的疟疾并发症。我们报告了一名间日疟原虫疟疾患者，他因DIC发展为感染性休克。一名25岁男性发热、腹痛、呕吐和恶心5天。临床检查时，患者情况危急，体温102.6°F，血压86/46 mmHg。全血细胞计数显示贫血、白细胞减少和严重血小板减少。外周血涂片检查结果显示红细胞中有间日疟原虫寄生虫，并有少量裂体细胞。进一步的凝血检查显示凝血酶原、部分凝血活酶时间和D-二聚体升高。DIC和感染性休克需要入住重症监护病房。青蒿琥酯和本芴醇的保守治疗使他完全康复。这个不寻常的病例表明，间日疟原虫可导致严重疟疾及其不良后果。它强调早期诊断和治疗以预防死亡和发病。
