Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations.
Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block), intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa) and the role of plasmapheresis in leptospira related jaundice with renal failure.
Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Luckow, Uttar Pradesh, India.
Sukhen
S
Samanta
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Sujay
S
Samanta
Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Rudrashish
R
Haldar
Intrapulmonary factor VIIa; malaria-leptospira co-infection; plasmapheresis; transverse abdominis plane block