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Acute pancreatitis, ascites, and acute renal failure in Plasmodium vivax malaria infection, a rare complication.

Lakhotia M, Pahadiya HR, Kumar H, Singh J, Sangappa JR, Choudhary PK - Trop Parasitol (2015 Jul-Dec)

Bottom Line: A 22-year-old male presented with 6 days history of intermittent fever with chills, 2 days history of upper abdomen pain, distension of abdomen, and decreased urine output.These constellations of complications in P. vivax infection have never been reported in the past.The patient responded to intravenous chloroquine and supportive treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India.

ABSTRACT
A 22-year-old male presented with 6 days history of intermittent fever with chills, 2 days history of upper abdomen pain, distension of abdomen, and decreased urine output. He was diagnosed to have Plasmodium vivax malaria, acute pancreatitis, ascites, and acute renal failure. These constellations of complications in P. vivax infection have never been reported in the past. The patient responded to intravenous chloroquine and supportive treatment. For renal failure, he required hemodialysis. Acute pancreatitis, ascites, and acute renal failure form an unusual combination in P. vivax infection.

No MeSH data available.


Related in: MedlinePlus

Peripheral blood film showing trophozoite ring of Plasmodium vivax malaria
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Figure 1: Peripheral blood film showing trophozoite ring of Plasmodium vivax malaria

Mentions: The peripheral blood film showed ring form of trophozoite of P. vivax [Figure 1]. The antigen testing including parasite LDH tested positive for P. vivax and negative for P. falciparum. The chest X-ray PA view and two-dimensional echocardiogram were normal. Ultrasonography of abdomen showed bulky pancreas, moderate ascites, and edematous both kidneys. There was no gallstone. A non contrast computerised tomography scan of the abdomen revealed finding suggestive of acute pancreatitis [Figure 2a and b]. Ascitic fluid examination was hemorrhagic and had protein 3.0 g/dL, sugar 110 g/dL, white blood cell 2200 mm3 with 83% neutrophils, 11% lymphocyte, 6% monocyte, and numerous red blood cell (RBC). The ascitic fluid amylase was 550 U/L. A diagnosis of P. vivax infection, acute pancreatitis, acute renal failure, and shock was made. The patient was put on intravenous chloroquine, inotropic support, and antibiotics. The BP normalized after 2 days of treatment. He tested negative for P. vivax after 3 days of treatment. After normalization of BP, he was put on hemodialysis. He improved over a period of next 4 weeks and was discharged. At the time of discharge, his blood urea was 56 mg/dL, S. creatinine 1.1 mg/dL, C-reactive protein was 4 mg/dL. Other investigations had normalized.


Acute pancreatitis, ascites, and acute renal failure in Plasmodium vivax malaria infection, a rare complication.

Lakhotia M, Pahadiya HR, Kumar H, Singh J, Sangappa JR, Choudhary PK - Trop Parasitol (2015 Jul-Dec)

Peripheral blood film showing trophozoite ring of Plasmodium vivax malaria
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4557151&req=5

Figure 1: Peripheral blood film showing trophozoite ring of Plasmodium vivax malaria
Mentions: The peripheral blood film showed ring form of trophozoite of P. vivax [Figure 1]. The antigen testing including parasite LDH tested positive for P. vivax and negative for P. falciparum. The chest X-ray PA view and two-dimensional echocardiogram were normal. Ultrasonography of abdomen showed bulky pancreas, moderate ascites, and edematous both kidneys. There was no gallstone. A non contrast computerised tomography scan of the abdomen revealed finding suggestive of acute pancreatitis [Figure 2a and b]. Ascitic fluid examination was hemorrhagic and had protein 3.0 g/dL, sugar 110 g/dL, white blood cell 2200 mm3 with 83% neutrophils, 11% lymphocyte, 6% monocyte, and numerous red blood cell (RBC). The ascitic fluid amylase was 550 U/L. A diagnosis of P. vivax infection, acute pancreatitis, acute renal failure, and shock was made. The patient was put on intravenous chloroquine, inotropic support, and antibiotics. The BP normalized after 2 days of treatment. He tested negative for P. vivax after 3 days of treatment. After normalization of BP, he was put on hemodialysis. He improved over a period of next 4 weeks and was discharged. At the time of discharge, his blood urea was 56 mg/dL, S. creatinine 1.1 mg/dL, C-reactive protein was 4 mg/dL. Other investigations had normalized.

Bottom Line: A 22-year-old male presented with 6 days history of intermittent fever with chills, 2 days history of upper abdomen pain, distension of abdomen, and decreased urine output.These constellations of complications in P. vivax infection have never been reported in the past.The patient responded to intravenous chloroquine and supportive treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India.

ABSTRACT
A 22-year-old male presented with 6 days history of intermittent fever with chills, 2 days history of upper abdomen pain, distension of abdomen, and decreased urine output. He was diagnosed to have Plasmodium vivax malaria, acute pancreatitis, ascites, and acute renal failure. These constellations of complications in P. vivax infection have never been reported in the past. The patient responded to intravenous chloroquine and supportive treatment. For renal failure, he required hemodialysis. Acute pancreatitis, ascites, and acute renal failure form an unusual combination in P. vivax infection.

No MeSH data available.


Related in: MedlinePlus