Document Detail


Shock complicating severe falciparum malaria in European adults.
MedLine Citation:
PMID:  9255652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
F Bruneel; B Gachot; J F Timsit; M Wolff; J P Bédos; B Régnier; F Vachon
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  23     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-10-09     Completed Date:  1997-10-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  698-701     Citation Subset:  IM    
Affiliation:
Clinique de Réanimation des Maladies Infectieuses, Groupe Hospitalier Bichat-Claude Bernard, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antimalarials / therapeutic use
Female
Humans
Malaria, Falciparum / complications*,  drug therapy
Male
Quinine / therapeutic use
Retrospective Studies
Severity of Illness Index
Shock, Septic / etiology*
Chemical
Reg. No./Substance:
0/Antimalarials; 130-95-0/Quinine

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