Severe Imported Malaria in Critical Care Patients

Detalhes bibliográficos
Autor(a) principal: Palma dos Reis, Inês
Data de Publicação: 2012
Outros Autores: Serafim, Catarina, Valério, Bernardino, Araújo, Robson, Silvestre, Joana, Mendes, Vítor, Tapadinhas, Camila, Gonçalves Pereira, João, Póvoa, Pedro
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285
Resumo: Introduction: Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate. Material and Methods: We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus on risk factors, clinical presentation, treatment and results. Results: All patients had a history of recent travel to African endemic areas for malaria. Plasmodium falciparum was the agent isolated in all cases. Most patients had an inadequate prophylaxis. High parasitaemia in non-immune patients and treatment delay were associated with more severe clinical presentation. All the cases were complicated by organ failure, and three patients needed organ support and in two exchange blood transfusions were performed. There was one single death that was associated with marked delay in the initiation of therapy. Conclusion: In these patients, early and aggressive treatment, with a organ support in a critical care setting, allowed a good outcome with low mortality and no significant sequelae, despite the severity of presentation.
id RCAP_d33fc9e86c2eed6c9e8196914f7db762
oai_identifier_str oai:ojs.www.actamedicaportuguesa.com:article/285
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Severe Imported Malaria in Critical Care PatientsMalária Grave Importada em Doentes CríticosIntroduction: Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate. Material and Methods: We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus on risk factors, clinical presentation, treatment and results. Results: All patients had a history of recent travel to African endemic areas for malaria. Plasmodium falciparum was the agent isolated in all cases. Most patients had an inadequate prophylaxis. High parasitaemia in non-immune patients and treatment delay were associated with more severe clinical presentation. All the cases were complicated by organ failure, and three patients needed organ support and in two exchange blood transfusions were performed. There was one single death that was associated with marked delay in the initiation of therapy. Conclusion: In these patients, early and aggressive treatment, with a organ support in a critical care setting, allowed a good outcome with low mortality and no significant sequelae, despite the severity of presentation.Introdução: A malária importada é um diagnóstico frequente em Portugal, podendo apresentar nas suas formas mais graves, elevada mortalidade.Material e Métodos: Apresentam-se sete casos de malária grave importada, admitidos numa unidade de cuidados intensivos entre 2000 e 2010, com especial enfoque nos factores de risco, apresentação clínica, terapêutica e resultados.Resultados: Todos os doentes tinham história de viagens recentes a zonas africanas endémicas para malária. O agente isolado foi sempre o Plasmodium falciparum. A maioria dos doentes não fez profilaxia adequada. A parasitémia elevada em doentes não imunes e o atraso no início do tratamento associaram-se a quadros clínicos mais graves. Todos estes casos de malária foram complicados por falência orgânica intercorrente, sendo que três dos doentes tiveram de ser submetidos a técnicas de suporte de órgão e dois a exsanguíneo-transfusões. Verificou-se um óbito, associado ao atraso no início da terapêutica.Conclusão: Nestes doentes o tratamento precoce e agressivo, com suporte dos órgãos em falência, em cuidados intensivos, permitiu uma boa evolução, com baixa mortalidade e ausência de sequelas significativas, apesar da gravidade de apresentação.Ordem dos Médicos2012-11-12info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/x-pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285oai:ojs.www.actamedicaportuguesa.com:article/285Acta Médica Portuguesa; Vol. 25 No. 5 (2012): September-October; 271-276Acta Médica Portuguesa; Vol. 25 N.º 5 (2012): Setembro-Outubro; 271-2761646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285/80Direitos de Autor (c) 2012 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessPalma dos Reis, InêsSerafim, CatarinaValério, BernardinoAraújo, RobsonSilvestre, JoanaMendes, VítorTapadinhas, CamilaGonçalves Pereira, JoãoPóvoa, Pedro2022-12-20T10:55:58Zoai:ojs.www.actamedicaportuguesa.com:article/285Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:25.225780Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Severe Imported Malaria in Critical Care Patients
Malária Grave Importada em Doentes Críticos
title Severe Imported Malaria in Critical Care Patients
spellingShingle Severe Imported Malaria in Critical Care Patients
Palma dos Reis, Inês
title_short Severe Imported Malaria in Critical Care Patients
title_full Severe Imported Malaria in Critical Care Patients
title_fullStr Severe Imported Malaria in Critical Care Patients
title_full_unstemmed Severe Imported Malaria in Critical Care Patients
title_sort Severe Imported Malaria in Critical Care Patients
author Palma dos Reis, Inês
author_facet Palma dos Reis, Inês
Serafim, Catarina
Valério, Bernardino
Araújo, Robson
Silvestre, Joana
Mendes, Vítor
Tapadinhas, Camila
Gonçalves Pereira, João
Póvoa, Pedro
author_role author
author2 Serafim, Catarina
Valério, Bernardino
Araújo, Robson
Silvestre, Joana
Mendes, Vítor
Tapadinhas, Camila
Gonçalves Pereira, João
Póvoa, Pedro
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Palma dos Reis, Inês
Serafim, Catarina
Valério, Bernardino
Araújo, Robson
Silvestre, Joana
Mendes, Vítor
Tapadinhas, Camila
Gonçalves Pereira, João
Póvoa, Pedro
description Introduction: Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate. Material and Methods: We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus on risk factors, clinical presentation, treatment and results. Results: All patients had a history of recent travel to African endemic areas for malaria. Plasmodium falciparum was the agent isolated in all cases. Most patients had an inadequate prophylaxis. High parasitaemia in non-immune patients and treatment delay were associated with more severe clinical presentation. All the cases were complicated by organ failure, and three patients needed organ support and in two exchange blood transfusions were performed. There was one single death that was associated with marked delay in the initiation of therapy. Conclusion: In these patients, early and aggressive treatment, with a organ support in a critical care setting, allowed a good outcome with low mortality and no significant sequelae, despite the severity of presentation.
publishDate 2012
dc.date.none.fl_str_mv 2012-11-12
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285
oai:ojs.www.actamedicaportuguesa.com:article/285
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285
identifier_str_mv oai:ojs.www.actamedicaportuguesa.com:article/285
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/285/80
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2012 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2012 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/x-pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 25 No. 5 (2012): September-October; 271-276
Acta Médica Portuguesa; Vol. 25 N.º 5 (2012): Setembro-Outubro; 271-276
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799130617869238272