Korean J Parasitol.  2006 Jun;44(2):139-143. 10.3347/kjp.2006.44.2.139.

Peripheral gangrene in patients with severe falciparum malaria: report of 3 cases

• Thanachartwet V
• Krudsood S
• Wilairatana P
• Phumratanaprapin W
• Silachamroon U
• Looareesuwan S

• KMID: 1720509
• DOI: http://doi.org/10.3347/kjp.2006.44.2.139

Abstract

Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patients with falciparum malaria. Patients with this complication have generally undergone early amputation of the affected areas. In this report, we describe 3 adult Thai patients presented at the Hospital for Tropical Diseases, Bangkok, with high grade of fever ranged 6-9 days, jaundice, acute renal failure, respiratory failure, alteration of consciousness and shock. Two patients had gangrene developed at the lower extremities on day 1 of hospitalization and 1 patient had gangrene developed on day 3. Blood smears revealed hyperparasitemia with Plasmodium falciparum. These patients were diagnosed as having severe malaria with peripheral gangrene. The resolution of gangrene was successfully achieved by treatment with artesunate and conservative treatment in 2 of 3 cases.

Keyword

Plasmodium falciparum; case report; gangrene; severe malaria; Thailand; artesunate

MeSH Terms

Middle Aged
Male
Malaria, Falciparum/*complications/drug therapy
Humans
Gangrene/*etiology
Female
Antimalarials/therapeutic use
Adult