Shock complicating severe falciparum malaria in European adults View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1997-06

AUTHORS

F. Bruneel, B. Gachot, J. F. Timsit, M. Wolff, J. P. Bédos, B. Régnier, F. Vachon

ABSTRACT

OBJECTIVE: To study adult patients with severe falciparum malaria who developed shock. DESIGN: Retrospective study from 1987 to 1993. SETTING: Medical intensive care unit in a university hospital. PATIENTS: 14 patients admitted with severe falciparum malaria who developed shock. All received intravenous quinine. MEASUREMENTS AND RESULTS: The mean Simplified Acute Physiology Score II was 59.5 +/- 7.1; 2.6 +/- 0.4 criteria defining severe disease were present on admission in 12 patients; and initial parasitemia was 21 +/- 6%. Twelve patients received inotropic drugs. Pulmonary artery catheterization showed the following results in 7 patients: mean arterial pressure 57 +/- 4 mmHg; pulmonary artery occlusion pressure 11 +/- 1 mmHg; cardiac index 5.5 +/- 0.91.min-1.m-2, and systemic vascular resistance index 783 +/- 122 dyne.s.cm-5.m-2. Seven patients had evidence of bacterial infection at the time of shock. Of the 7 deaths (50%), 5 were due to shock, with documented bacterial infection in all patients and persistent parasitemia in 4. CONCLUSIONS: Shock complicating severe falciparum malaria in adults is associated with peripheral vasodilation and carries a poor prognosis. In falciparum malaria with shock, bacterial coinfection should be suspected immediately and treated empirically with broad-spectrum antibiotics. Nevertheless, Plasmodium falciparum may contribute directly or indirectly to the onset of shock. More... »

PAGES

698-701

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s001340050396

DOI

http://dx.doi.org/10.1007/s001340050396

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1013041092

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/9255652


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