title: Peripheral gangrene in patients with severe falciparum malaria: report of 3 cases.
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.
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. tmvtn@mahidol.ac.th
authors.forename: Vipa
authors.initials: V
authors.lastname: Thanachartwet
authors.forename: Srivicha
authors.initials: S
authors.lastname: Krudsood
authors.forename: Polrat
authors.initials: P
authors.lastname: Wilairatana
authors.forename: Weerapong
authors.initials: W
authors.lastname: Phumratanaprapin
authors.forename: Udomsak
authors.initials: U
authors.lastname: Silachamroon
authors.forename: Sornchai
authors.initials: S
authors.lastname: Looareesuwan
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D005260:Female; D005734:Gangrene / Q000209:etiology*; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged
chemical_list: D000962:Antimalarials