1 / 17

Safari Souvenir

Safari Souvenir. A Case Study about Malaria by Michelle LeBlanc. Patient History & Physical. 49 year old man presenting to the Emergency Center with the following symptoms: Fever of 39.4 o C Vomiting for 2 days Neck and back pain. Patient History & Physical - continued .

brinley
Download Presentation

Safari Souvenir

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Safari Souvenir A Case Study about Malaria by Michelle LeBlanc

  2. Patient History & Physical • 49 year old man presenting to the Emergency Center with the following symptoms: • Fever of 39.4oC • Vomiting for 2 days • Neck and back pain

  3. Patient History & Physical - continued • Returned from a trip to Nigeria, Africa two weeks prior • Claims to have been taking anti-malarial medications • Presumptive Diagnosis = Malaria

  4. Laboratory Results

  5. Questions to consider: • How does malaria affect hematology results? • What is the effectiveness of prophylactic (anti-malarial) drugs? • What is the significance of the low platelet count?

  6. Blood Smear Findings • Plasmodium falciparum rings have delicate cytoplasm and 1 or 2 small chromatin dots.  Red blood cells (RBCs) that are infected are not enlarged; multiple infection of RBCs more common in P. falciparum than in other malaria species. 

  7. Treatment • Patient was given 500 cc of IV bolus in EC • He received 2 does of Mefluquine • Tylenol was given as needed for pain • He was prescribed Deoxycyclin for 7 days

  8. Plasmodium vivax Plasmodium malariae Plasmodium falciparum Plasmodium ovale Fever Chills Headache / muscle ache Nausea / vomiting Kidney damage Coma Death Types of Malaria / Symptoms

  9. Trasmission • Malaria is transmitted via the bite of an infected mosquito of the Anophelesspecies • The parasite enters the bloodstream and travels to the liver where it will grow and mature • Symptoms appear in 8 days to several months when the parasite enters the red blood cells

  10. Transmission

  11. Risk • Found in 40% of the world’s population in areas of Central and South America, Africa, India, SE Asia and the Middle East • Currently 12,000 cases are diagnosed in the United States each year • 300-500 million clinical cases occur each year worldwide

  12. Hematological Complications • Hemolysis due to increased osmotic and mechanical fragility of the erythrocytes • Decreased platelet count (thrombocytopenia) is associated with the use of some anti-malarial drugs

  13. Drug Therapy with Quinine • Quinine is one of the most commonly prescribed anti-malarial drugs • Quinine is the 2nd most common agent implicated in drug induced thrombocytopenia • It’s effectiveness is questioned due to increasing multidrug resistant malaria phenotypes • Patient probably did take his prescribed anti-malarial medication

  14. Human Resistance to Malaria • Hemoglobin S found in red blood cells of Sickle Cell Anemia • Hemoglobin F found in red blood cells of Thalassemia • The red blood cells containing these abnormal hemoglobins are more prone to ingestion by macrophages. Thus malaria organisms are more readily removed from the blood stream.

  15. Summary • 49 year old man presented to the EC with flu-like symptoms and decreased platelet count after returning from Africa two weeks prior • Claims to have taken “unknown” anti-malarial medications • Blood culture found no growth but Plasmodium falciparum was found on blood smear review • Patient released after 2 days with not follow-up required

  16. References • Images from DPDx – A web site developed and maintained by CDC's Division of Parasitic Diseases (DPD) http://www.dpd.cdc.gov/dpdx/HTML/Image_Library.htm Last accessed on 11/05/04.

  17. Credits This case study was prepared by Michelle Leblanc, MT(ASCP) while she was a Medical Technology student in the 2004 MT Class at William Beaumont Hospital, Royal Oak, MI.

More Related