| Shock complicating severe falciparum malaria in European adults. | |
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MedLine Citation:
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PMID: 9255652 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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F Bruneel; B Gachot; J F Timsit; M Wolff; J P Bédos; B Régnier; F Vachon |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Intensive care medicine Volume: 23 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 1997 Jun |
Date Detail:
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Created Date: 1997-10-09 Completed Date: 1997-10-09 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 698-701 Citation Subset: IM |
Affiliation:
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Clinique de Réanimation des Maladies Infectieuses, Groupe Hospitalier Bichat-Claude Bernard, Paris, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antimalarials; 130-95-0/Quinine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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