LIVER AND RENAL DYSFUNCTION IN PLASMODIUM FALCIPARUM MALARIA

Dr Harshal Joshi, Dr Prabhakar S Jirvankar

Abstract


Background –

Malaria still continues to be a major killer of mankind especially in developing countries.Almost all deaths and severe disease are due to plasmodium falciparum. It is observed that the patients of falciparum malaria with liver, renal and hematological abnormalities are more vulnerable to development of complications like cerebral malaria, anaemia, acute respiratory distress syndrome etc.

Methods –

50 cases of plasmodium falciparum malaria diagnosed by peripheral smear examination or by immunochromatographic tests were included in the study. All these patients are subjected to blood investigations like renal function test,liver function test, random blood sugar level(BSL).

Results-

68% patients were males with sex ratio M:F was 2.12: 1. Majority of patients  ( 26%) belong to age group of 21-30 years. Most common presentation  was fever in 100% of patients, followed by headache in 48% of patients, vomiting in 46% of patients. 42% patients were showed increased in  serum creatinine more than 1.2mg% with mean was 2.14+/-2.23 mg%  with range of  0.6 – 9.5 mg%. 38% patients were having increased  in  serum bilirubin more than 1.2mg%. with mean  was 2.87+/-4.72 mg%  with range of 0.58 – 25 mg%. Mean RBSL level was 98.3+/- 23.47 mg % with range of  54 – 190 mg%. 08% patients were having RBSL less than 60mg%.44% were having splenomegaly  and 28% were having hepatomegaly on USG report. Only 12% patients showing both hepatomegaly and splenomegaly on USG report. .P Falciparum malaria with renal and liver dysfunction mostly associated with coagulation abnormality with or without bleeding diathesis having bad prognosis.


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