Solunum yetmezliğinin eşlik ettiği Plasmodium vivax malaria olgusu

Abstract

Akut böbrek yetmezliği, dissemine intravasküler koagü­lasyon, akut solunum sıkıntısı sendromu (ARDS), hipog­lisemi, koma veya epileptik nöbet ağır Plasmodium fal­ciparum\'un bulgularıdır. Plasmodium vivax nadiren ciddi komplikasyonlara neden olur. Hastane bahçesinde bilinç­siz olarak bulunan 30 yaşında erkek Pakistanlı mülteci bir olguyu sunuyoruz. Yoğun bakım desteği gerektiren pnö­moni tedavisi ve yoğun bakım desteğinden sonra invaziv mekanik ventilasyondan ayrıldı. Devam eden ateş ve tit­reme atakları nedeniyle sıtma tanısı üzerine odaklanıldı, Plasmodium vivax kalın periferik yaymada tespit edildi. Yoğun bakım desteği ve spesifik antiplasmodial tedavi sonrası hasta iyileşti ve hastaneden taburcu edildi. ARDS ilişkili Plasmodium vivax\'da mekanik ventilasyon kullanı­mı olumlu sonuçla ilişkiliydi.

Keywords

• ARDS, Plasmodium vivax, pnömoni, Solunum yetmezliği

A case of Plasmodium vivax malaria with respiratory failure

Abstract

Acute renal failure disseminated intravascular coagula­tion, acute respiratory distress syndrome (ARDS), hypo­glycemia, coma or epileptic seizures are manifestations of severe Plasmodium (P.) falciparum malaria. P. vivax malaria is rarely associated with severe complications. We report a case of 30-year-old male refugee coming from Pakistan, has been found in hospital garden as un­conscious. After therapy of pneumonia requiring intensive care unit and intensive supportive care, the patient left invasive mechanical ventilation (IMV). Because of contin­ued fever and chills attacks focused on malaria diagnosis, Plasmodium vivax malaria detected on thick peripheral blood smear. After intensive supportive care and specific anti-plasmodial therapy, the patient recovered and was discharged from hospital. The use of IMV vivax-malaria related ARDS was associated with a good outcome. J Clin Exp Invest 2013; 4 (2): 226-228 Key words: ARDS, Plasmodium vivax, pneumonia, re­spiratory failure

Keywords

• ARDS, Plasmodium vivax, pneumonia, re­spiratory failure

References

1. Greenwood BM, Fidock DA, Kyle DE, et al. Malaria: progress, perils, and prospects for eradication. J Clin Invest 2008;118:1266-1276.
2. Kumar S, Melzer M, Dodds P, et al. Vivax malaria complicated by shock and ARDS. Scand J Infect Dis. 2007;39:255-256.
3. Price L, Planche T, Rayner C, Krishna S. Acute respira- tory distress syndrome in Plasmodium vivax malaria: Case report and review of the literature. Trans R Soc Trop Med Hyg 2007;101:655-659.
4. Kasliwal P, Rao MS, Kujur R. Plasmodium vivax ma- laria: An unusual presentation. Indian J Crit Care Med 2009;13:103-105.
5. Nayak KC, Mohini S, Kumar RS, et al. A study on pul- monary manifestations in patients with malaria from Northwestern India (Bikaner). J Vector Borne Dis 2011;48:219-223.
6. Mishra U, Ray G. Pulmonary manifestation of malaria. Chest 2005;128:376.
7. Anstey NM, Jacups SP, Cain T, et al. Pulmonary mani- festations of uncomplicated falciparum and vivax ma- laria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis 2002;185:1326-1334.
8. McGready R, Davison BB, Stepniewska K, et al. The ef- fects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission. Am J Trop Med Hyg 2004;70:398-407.

9. Sarkar S, Saha K, Das CS. Three cases of ARDS: An emerging complication of Plasmodium vivax malaria. Lung India 2010;27:154-157.
10. Agarwal R, Nath A, Gupta D. Noninvasive ventilation in Plasmodium vivax related ALI/ARDS. Intern Med. 2007;46:2007-2011.