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Peripheral gangrene in nonfatal pediatric cerebral malaria: a report of two cases.

Authors
  • Chittichai, P
  • Chierakul, N
  • Davis, T M
Type
Published Article
Journal
The Southeast Asian journal of tropical medicine and public health
Publication Date
Jun 01, 1991
Volume
22
Issue
2
Pages
190–194
Identifiers
PMID: 1948278
Source
Medline
License
Unknown

Abstract

Two Thai girls aged 10 and 13 years from the same rural area were admitted to Paholpolpayuhasena Hospital, Kanchanaburi, Thailand during the rainy season of 1989 with cerebral malaria. After several days of conventional treatment, both developed gangrene involving the feet and toes, but the lesions healed and no other complications were seen. In the absence of convincing clinical and laboratory evidence of vasculitis or coagulopathy, it seems likely that host factors (dehydration, sluggish peripheral circulation, platelet activation, subclinical intravascular coagulation) combined with strain-specific parasite factors (tissue sequestration of mature forms, rosette formation) may predispose to peripheral microvascular occlusion sufficient to produce infarction of tissue in susceptible children. However, despite the apparently ominous appearance of such lesions in a comatose child, the prognosis seems good.

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