Desai S P, Vora I M, Phatak A M, Bhalerao M
Department of Pathology, T.N. Medical College & B.Y.L. Nair Hospital, Mumbai.
Indian J Pathol Microbiol. 1996 Dec;39(5):477-9.
A retrospective analysis of fifty cases where falciparum malaria was detected at autopsy, was done. Histopathological sections from all organs were taken. Cerebral malaria was seen in 44 cases on histology. Plugging of cerebral vasculature by parasitised erythrocytes (pRBC) was seen in all cases while Durck granulomas were seen in 5 cases. Multiple organ involvement was seen in form of sequestration of pRBC in all the cases. Positive peripheral smear was obtained in only 20 cases (antemortem). Twenty-nine patients had jaundice of which 18 had altered sensorium. They were clinically diagnosed as hepatic failure with or without hepatic encephalopathy. Fever as a symptom was seen in 19 patients. Age varied from 14 years to 80 years. Twenty-three patients died within 12 hours of admission, 12 other patients expired within a day. Only two cases survived more than a week. Specific antimalarial therapy was administered to 29 patients of which only 11 cases received quinine.
对50例尸检时检测到恶性疟原虫的病例进行了回顾性分析。采集了所有器官的组织病理学切片。组织学检查发现44例有脑型疟疾。所有病例均可见被寄生红细胞（pRBC）阻塞脑血管，5例可见杜尔克肉芽肿。所有病例均可见以pRBC扣押形式出现的多器官受累。仅20例（生前）外周血涂片呈阳性。29例患者出现黄疸，其中18例有感觉改变。他们临床诊断为伴有或不伴有肝性脑病的肝衰竭。19例患者有发热症状。年龄从14岁到80岁不等。23例患者在入院后12小时内死亡，另外12例患者在一天内死亡。只有2例存活超过一周。29例患者接受了特异性抗疟治疗，其中只有11例接受了奎宁治疗。
