Peripheral gangrene in patients with severe falciparum malaria: report of 3 cases
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Abstract
Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patientswith falciparum malaria. Patients with this complication have generally undergone early amputation of the affectedareas. In this report, we describe 3 adult Thai patients presented at the Hospital for Tropical Diseases, Bangkok, withhigh grade of fever ranged 6-9 days, jaundice, acute renal failure, respiratory failure, alteration of consciousness andshock. Two patients had gangrene developed at the lower extremities on day 1 of hospitalization and 1 patient hadgangrene developed on day 3. Blood smears revealed hyperparasitemia with Plasmodium falciparum. These patientswere diagnosed as having severe malaria with peripheral gangrene. The resolution of gangrene was successfullyachieved by treatment with artesunate and conservative treatment in 2 of 3 cases.
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