title: Malaria complicated by gangrene: a case presentation and review.
abstract: Symmetrical peripheral gangrene (SPG) is an extremely rare complication of malaria. It occurs acutely and progresses rapidly to cause irreversible necrosis of tissue following which debridement or amputation is inevitable. We present a case of malaria complicated by SPG. A 54-year old male developed SPG two days after he was diagnosed with severe malaria and treated with intravenous quinine. Despite intervention quad-amputation was necessary as the gangrene had involved all four limbs. SPG secondary to malaria is caused by obstruction of arterioles following sequestration of parasite infected erythrocytes. This is extremely rare, hence almost never anticipated during management of malaria patients. Furthermore due to its rapid progression, it is almost always detected at an advanced irreversible stage. Physicians managing malaria should therefore be vigilant, and look out for SPG, as its prognosis is dependent on correct and timely intervention.
authors.affiliation: School of Medicine, University of Nairobi, PO Box 30197-00100, Nairobi, Kenya.
authors.forename: Faraj Omar
authors.initials: FO
authors.lastname: Alkizim
authors.forename: Duncan
authors.initials: D
authors.lastname: Matheka
authors.forename: Otieno Walter
authors.initials: OW
authors.lastname: Mwanda
mesh_terms: D000671:Amputation, Surgical / Q000379:methods; D000962:Antimalarials / Q000627:therapeutic use; D018450:Disease Progression; D004912:Erythrocytes / Q000469:parasitology; D005734:Gangrene / Q000469:parasitology* / Q000601:surgery; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011803:Quinine / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000962:Antimalarials; D011803:Quinine