Komplizierte Malaria tropica: spezifische und supportive Therapie bei importierten Erkrankungen
| Autor: | Thomas Löscher, Hans-Dieter Nothdurft, F. von Sonnenburg, L. Prüfer |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Disseminated intravascular coagulation
medicine.medical_specialty business.industry Secondary infection medicine.medical_treatment Acute kidney injury Exchange transfusion General Medicine medicine.disease Haemolysis Cerebral Malaria Internal medicine parasitic diseases medicine Acute pancreatitis business Malaria |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 111:934-938 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2008-1068559 |
| Popis: | Eleven of 43 nonimmune patients with falciparum malaria had one or several organ complications: cerebral malaria, acute respiratory failure, acute renal failure, secondary infection, autoimmune haemolysis, spontaneous spleen rupture, and acute pancreatitis. Parasitaemia was 0.1 to 60%. Initial antiparasitic therapy with quinine given parenterally resulted in rapid regression of parasitaemia. An additional schizonticide agent was given depending on parasitic resistance. Supportive therapy comprised intensive-care monitoring including fluid and electrolyte balance and, if necessary, early haemodialysis and (or) endotracheal intubation with PEEP breathing. In one patient with excessive parasitaemia exchange transfusion was performed. Heparin was given only in proven disseminated intravascular coagulation, corticosteroids only in persistent autoimmune haemolysis. All patients survived without suffering permanent defects. Retrospective analysis shows that, apart from rapid specific therapy, supportive treatment of the individual organ complications determines course and prognosis of complicated falciparum malaria. |
| Databáze: | OpenAIRE |
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