Volume 11, Number 1—January 2005
Dispatch
Plasmodium vivax Malaria
, Vishal Saxena†, Narvachan Singh*, Sanjay K. Kochar*, S. Vijay Kumar†, and Ashis Das†
Table 1
Clinical characteristics of severe vivax malaria patients
| Patient No. | Age (y)/sex | Clinical presentation* | Parasitemia (density) (P. vivax/mm3) | Diagnostic tests for malaria |
Other relevant information | Outcome | ||
|---|---|---|---|---|---|---|---|---|
| PBF | RMDT OptiMAL test† | PCR | ||||||
| 1 | 30, F | ARDS | 6,000 | + | Positive | + | Skiagram chest suggestive of pulmonary edema | Died |
| 2 | 17, M | Renal failure, bleeding diathesis | 20,000 | + | Positive | + | PT >60 (Control – 16) BT, CT, PT – N | Recovered |
| 3 | 53, M | Jaundice‡ | 35,000 | + | Positive | + | Epistaxis, hemoglobinurea BT, CT, PT – N | Recovered |
| 4 | 20, F | Cerebral (GCS– 3) anemia, ARDS, PCF | 15,000 | + | Positive | + | BP <70 mmHg (systolic) CSF – N CT scan head – could not be done | Died within 5 of admission |
| 5 | 45, M | Renal failure, jaundice‡ | 36,000 | + | Positive | + | Recovered | |
| 6 | 22, F | Cerebral (GCS – 6) anemia | 8,000 | + | Positive | + | Puerpural period 3rd gravida CSF – N CT scan head – N | Recovered Baby died on 14th day at residence |
| 7 | 18, F | Cerebral (GCS – 5) anemia | 10,000 | + | Positive | + | Primigravida CSF – Normal CT scan head – N | Recovered PMNS - Psychosis Premature delivery Baby survived |
| 8 | 28, F | Renal failure, ARDS, PCF | 44,000 | + | Positive | + | Gross hematuria BP <70 mm Hg systolic | Recovered |
| 9 | 25, F | Jaundice‡, haemoglobinurea | 90,400 | + | Positive | + | Secondgravida | Recovered Pregnancy continued |
| 10 | 50, M | Jaundice‡ | 18,000 | + | Positive | + | Recovered | |
| 11 | 18, F | Renal failure, anemia, pulmonary edema | 34,000 | + | Positive | + | Skiagram chest – pulmonary edema | Recovered Underwent hemodialysis |
*All patients were fully conscious except patients 4, 6, and 7. ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BT, bleeding time; CT, clotting time; CT, computerized tomography scan of head (non-contrast); F, female; GCS, Glasgow coma scale; LDH, lactate dehydrogenase; M, male; N, normal; PBF, peripheral blood film; PCR, polymerase chain reaction; PMNS, post malarial neurologic syndrome; PT, prothrombin time; TLC, total leukocyte count; RMDT, rapid malaria diagnostic test.
†Positive for Plasmodium vivax, malariae, or ovale because of common LDH isoenzyme antigen and negative for P. falciparum.
‡Relevant investigations were done to rule out viral hepatitis and leptospirosis in all patients with jaundice.