Biology Reference
In-Depth Information
8.1.2. Acute lung injury and respiratory distress
There have been over 20 reports of well-defined ALI and ARDS as a single
complication of PCR-confirmed
P. vivax
. Initial reports were mostly man-
aged in non-endemic country hospitals, with a very low case-fatality rate
and with the majority occurring after commencement of antimalarial drug
treatment (see
Price et al., 2007a
;
Tan et al., 2008
;
Habib and Singh, 2004
;
Lawn et al., 2003
;
Pukrittayakamee et al., 1998
;
Torres et al., 1997
;
Kotwal
et al., 2005
;
Maguire et al., 2005
;
Curlin et al., 1999
;
Carlini et al., 1999
;
Munteis et al., 1997
;
Saleri et al., 2006
;
Tanios et al., 2001
;
Kumar et al.,
2007
;
Agarwal et al., 2007
;
Taylor et al., 2012
for review). One report from
India of a 20-year-old woman with PCR- and autopsy-confirmed vivax
malaria documents presentation with ARDS pre-treatment, resulting in a
fatal outcome (
Valecha et al., 2009
).
More recently reported cases of ALI/ARDS in adults have mostly been
part of larger series of severe vivax malaria from endemic settings, generally
with less-clearly defined ARDS criteria, occurring as part of multiple organ
dysfunction/failure (
Kochar et al., 2005
,
2009
;
Andrade et al., 2010
;
Alexan-
dre et al., 2010
). Clinical ARDS/'respiratory failure' occurred in 10-32% of
patients with severe malaria and had a case-fatality rate of 50-67% (
Kochar
et al., 2005
,
2009
;
Andrade et al., 2010
;
Alexandre et al., 2010
), much higher
than the very low fatality rate seen in reports of single-organ ARDS (
Taylor
et al., 2012
).
In the Brazilian autopsy series, 15 of 17 (88%) had respiratory distress
before death, again mostly commencing after the start of antimalarial drug
treatment (
Lacerda et al., 2012
). ARDS and/or lung oedema was identified
as the commonest complication contributing to death, occurring in six
overall (35%) and in three of the four (75%), in whom vivax was considered
the direct cause of death (
Lacerda et al., 2012
). In two of the latter cases,
lung oedema occurred in conjunction with other major pathology (one
each with coma/encephalitis and splenic rupture) (
Lacerda et al., 2012
).
8.1.3. Coma and other vivax-associated neurological complications
Coma is a common complication of
P. falciparum
infection comprising
approximately 50% of adult severe falciparum malaria complications
(
Yeo et al., 2007
;
Dondorp et al., 2008
;
Hien et al., 1996
). In contrast,
coma is a less-common manifestation of vivax malaria. From 1921 to
2011, over 100 cases of
P. vivax
monoinfection in adults and children
associated with coma were described in reports or series (
Kochar et al.,
2005
,
2009
,
2010
;
Lampah et al., 2011
;
Tanwar et al., 2011
;
Romanenko,
