A Prospective Study Of Hepatic Involvement In Plasmodium Falciparum Malaria
Dr. Rakendra Singh (Asst. Prof.)
Department of Internal Medicine, Adesh Institute of Medical Sciences & Research.Bathinda, Punjab, India-151001.
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Introduction: Malaria counts among the worst scourges of humankind. It amounts to an immeasurable health burden and inhibits economic prosperity in numerous tropical countries.
Material & Methods: The study included adult patients with Plasmodium Falciparum malaria with evidence of jaundice conventional thick and thin Pbfs stained with geimsa were examined under oil immersion. Detailed clinical, biochemical, and radiological examinations were conducted to establish the diagnosis of malaria and the various clinical manifestations. Histopathological examination was conducted in the category B of the patients.
Observations: About two thirds were male. The age of the patients ranged between 16-56 years (mean 28.14Â±7.23). Serum bilirubin levels ranged from 1 to 32 mg% (mean 5.65). 41.46% had serum bilirubin of <3 mg%, 40.24% had 3-10 mg% and 18.29% had >10 mg%.
The most frequent sonographic finding of liver was normal sized liver with normal echogenicity. Swollen hepatocytes was seen in all the cases while hemozoin deposition seen in about three fourths.80% of the patients with serum bilirubin >10mg developed acute renal failure as compared to 17.65% in those with bilirubin level <3 mg.
Conclusion: Hepatic involvement is a common accompaniment of acute P. Falciparum malaria, and hepatic dysfunction ranges from a mild elevation of liver enzymes to the range of acute hepatitis.the presence of hepatitis in patients with falciparum malaria indicates a more severe illness with a higher incidence of complications, multiorgan failure and supposedly a bad prognosis.