1
|
Holla VV, Pal PK. Overview of management of infection-related movement disorders with focus on specific-infections. Clin Park Relat Disord 2024; 10:100233. [PMID: 38304096 PMCID: PMC10831291 DOI: 10.1016/j.prdoa.2024.100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/09/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Infections are important treatable causes of secondary movement disorders (MD) that can have heterogeneous presentations. According to various studies, infection-related movement disorders (IRMD) account for around 10-20% of secondary MD. Certain infections have a predilection for causing various MD, and some MD phenomenologies, such as acute cerebellar ataxia and opsoclonus-myoclonus-ataxia syndromes (OMAS), suggest a strong possibility of an underlying infectious cause. The underlying pathophysiology is multifaceted, including direct neuronal damage due to neurotropism, granulomas, abscesses causing structural damage, and inflammatory and autoimmune responses triggered by infections. Understanding the prevalence, spectrum, and pattern of these IRMD and common infections that are responsible helps in early diagnosis, and instituting appropriate, timely treatment, thereby improving the overall prognosis and avoiding unnecessary investigations. In this review, we aim to provide a brief overview of common infections associated with MD, common clinical presentations of IRMD, their underlying pathophysiology, and overall approach to their treatment, with a focus on specific treatments of prevalent and treatable IRMD.
Collapse
Affiliation(s)
- Vikram V Holla
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, Karnataka, India
| |
Collapse
|
2
|
Pandey O, Hona E, Shrestha E, Khadka V, Ghising T. Unusual Presentation and Difficult to Diagnose: A Case of Malaria With Negative Thick and Thin Giemsa Stain Smear Tests. Cureus 2023; 15:e39675. [PMID: 37398749 PMCID: PMC10308142 DOI: 10.7759/cureus.39675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
Malaria is a parasitic disease that is spread by the bite of an Anopheles mosquito carrying the infection. Microscopic analysis of thick and thin Giemsa-stained smears is the gold standard for diagnosis. If the initial test is negative, but clinical suspicion is high, further smears are required. A 25-year-old man presented with abdominal distension, cough, and a seven-day fever. In addition, the patient developed pleural effusions and ascites. The thick and thin smear tests for malaria and all other fever testing came out negative. Plasmodium vivax was later identified by reverse transcription polymerase chain reaction (RT-PCR). There was a considerable improvement once the anti-malarial medicine was started. It was difficult to diagnose him because pleural effusion and ascites are unusual for someone with malaria. Furthermore, several Giemsa stain smears and malaria quick diagnostic tests were negative, and only a few labs in our country performed RT-PCR.
Collapse
Affiliation(s)
- Oshna Pandey
- School of Medicine, Patan Academy of Health Sciences, Kathmandu, NPL
| | - Elisha Hona
- Internal Medicine, Nepal Korea Friendship Municipality Hospital, Bhaktapur, NPL
| | | | - Varsha Khadka
- Internal Medicine, Nepal Korea Friendship Municipality Hospital, Bhaktapur, NPL
| | - Tsewang Ghising
- Internal Medicine, Nepal Korea Friendship Municipality Hospital, Bhaktapur, NPL
| |
Collapse
|
3
|
Biswal D, Mirdha BR. A case of atypical vivax malaria with a global review of reports on myriads of morpho-variations in parasitized red blood cells. Access Microbiol 2023; 5:000461.v3. [PMID: 37223061 PMCID: PMC10202396 DOI: 10.1099/acmi.0.000461.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 02/07/2023] [Indexed: 05/25/2023] Open
Abstract
Plasmodium vivax, one of the major species associated with human malaria, continues to be a major public health problem in many parts of the world. Numerous studies related to vivax malaria have described quantitative haematological findings (level of haemoglobin, thrombocytopaenia, haematocrit values), but diverse morphological changes of parasite forms within infected red blood cells (iRBCs) have been mentioned only in few studies. Here we report a case of a 13-year-old boy who presented with fever, significant low platelet counts and hypovolaemia that created a diagnostic dilemma. Detection of microgametocytes by microscopic examinations, further confirmed by multiplex nested PCR assays and response to anti-malarials, helped to make the diagnosis. We present an atypical case of vivax malaria with a review of morpho-variations of iRBCs and have summarized the characteristics that aid in creating increased awareness among laboratory health professionals and public health workers.
Collapse
Affiliation(s)
- Debasish Biswal
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bijay Ranjan Mirdha
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
4
|
Muacevic A, Adler JR, Zamora N, Aaron Lee HT, Balassiano N, Abdelmoteleb S, Khan MG, Abosheaishaa H, Ahmed K. Silent Bowels From a Silent Bite: A Rare Case of Paralytic Ileus Complicating Plasmodium falciparum Infection. Cureus 2023; 15:e34061. [PMID: 36824555 PMCID: PMC9943535 DOI: 10.7759/cureus.34061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 01/23/2023] Open
Abstract
Malaria is a life-threatening, parasitic disease that continues to infect millions of people, especially in endemic regions. Despite advancements in malaria treatment, treating the disease remains challenging. One major challenge is identifying the disease from its unconventional manifestations. Therefore, recognizing its unusual clinical presentations is imperative in early detection and management with a better prognosis. This case report highlights the unique finding of paralytic ileus from a patient with confirmed malaria. Further investigation on the concurrence between paralytic ileus and malaria may aid in identifying the disease and subsequent improvement in treatment.
Collapse
|
5
|
Jiero S, Pasaribu AP. Haematological profile of children with malaria in Sorong, West Papua, Indonesia. Malar J 2021; 20:126. [PMID: 33663524 PMCID: PMC7931533 DOI: 10.1186/s12936-021-03638-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.
Collapse
Affiliation(s)
- Syilvia Jiero
- Department of Child Health, Sorong Regional General Hospital, Sorong, West Papua, Indonesia
| | - Ayodhia Pitaloka Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Dr. Mansur Street No. 5, 20156, Medan, Indonesia.
| |
Collapse
|
6
|
Albashir AAD. A case of Falciparum malaria presenting with features of functional bowel obstruction. Oxf Med Case Reports 2020; 2020:omaa098. [PMID: 33133627 PMCID: PMC7583405 DOI: 10.1093/omcr/omaa098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/20/2020] [Accepted: 09/03/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Malaria is the most common tropical disease in Sudan, which is caused by an infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. Headache, fever, cough, fatigue, malaise, shaking chills, arthralgia and myalgia are the cardinal features of malaria, but occasionally, it has an atypical presentation. Intestinal obstruction as a complication is an extremely rare presentation. Here within, we describe a 28-year-old Sudanese man who has presented with of colicky abdominal pain, absolute constipation for two days and fever. Blood film for malaria was positive for Plasmodium falciparum. Intravenous artesunate injections have resulted in the resolution of symptoms of bowel obstruction. In conclusion, malaria should be suspected in any febrile patient with the features of bowel obstruction especially in an endemic area or if the patient has recently travelled to an endemic area with malaria. Treatment of malaria will result in the resolution of symptoms of functional bowel obstruction.
Collapse
|
7
|
Ünal E, Arslan S, Onur MR, Akpinar E. Parasitic diseases as a cause of acute abdominal pain: imaging findings. Insights Imaging 2020; 11:86. [PMID: 32691171 PMCID: PMC7371776 DOI: 10.1186/s13244-020-00892-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022] Open
Abstract
Acute abdominal pain can be seen in cases with parasitic diseases delivered to emergency departments. The diagnosis of the parasitic disease can be delayed because of the similar clinical signs encountered in other frequently seen causes of acute abdomen. Nevertheless, the features detected in imaging scans can be helpful in the diagnosis. The present study aims to raise awareness about abdominal parasitosis in emergency conditions and also to underline the association between imaging findings and the life cycle of parasites with illustrative cases.
Collapse
Affiliation(s)
- Emre Ünal
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey.
| | - Sevtap Arslan
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | - Mehmet Ruhi Onur
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | - Erhan Akpinar
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| |
Collapse
|
8
|
Maheshwari N, Shaikh M, Chand R, Maheshwari H, Yasir M. Malarial Hepatopathy in Children Visiting a Tertiary Healthcare Hospital in Karachi. Cureus 2020; 12:e6696. [PMID: 32104632 PMCID: PMC7026864 DOI: 10.7759/cureus.6696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To determine the frequency of malarial hepatopathy in children that are visiting Lyari General Hospital in Karachi, Pakistan. Study design Cross sectional descriptive study. Material and methods Patients with age between two months and 15 years, who had positive blood film for Plasmodium falciparum or P. vivax, were included in the study. All patients were monitored for malarial hepatopathy. Result A total of 241 cases were included in the study. Mean age at admission was 4.1 ± 1.3 years and male to female ratio was 1.2:1. There were 133 (55.2%) cases of P. vivax, while 108 (44.8%) were of P. falciparum. Malarial hepatopathy was observed in 37 patients (15.4%). Malaria hepatopathy was present in 24.1% and 8.3% children having P. falciparum and P. vivax, respectively. Malaria hepatopathy was present in 24%, 18% and 6% in age groups two months to five years, >5 years to 10 years and >10 years, respectively. Conclusion Malarial hepatopathy was observed in about one-sixth of study population and it was more common between two months and five years age group.
Collapse
Affiliation(s)
| | - Mehmood Shaikh
- Neonatal Intensive Care Unit, Jinnah Sindh Medical University, Karachi, PAK
| | - Rewa Chand
- Pediatric Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | | | - Mehrunnisa Yasir
- Medical Intensive Care Unit, National Institute of Child Health, Karachi, PAK
| |
Collapse
|
9
|
Bonghaseh TD, Ekaney DSM, Budzi M, Ekwen G, Kyota S. Sub-acute intestinal obstruction - a rare complication of Plasmodium falciparum malaria in an adult: a case report. J Med Case Rep 2018; 12:190. [PMID: 29966528 PMCID: PMC6029377 DOI: 10.1186/s13256-018-1730-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria remains a major public health problem in most tropical countries. It occasionally presents with both typical and atypical signs and symptoms. Gastrointestinal manifestations are common in malaria endemic areas but intestinal obstruction as a complication is extremely rare. CASE PRESENTATION We present the case of a 42-year-old black African man who presented with signs and symptoms of intestinal obstruction and was diagnosed as having Plasmodium falciparum malaria. He was successfully treated with both parenteral and orally administered antimalarial medication and the intestinal obstruction subsequently resolved. CONCLUSION With intestinal obstruction being an important cause of morbidity and mortality, we report this case to highlight this rare complication of malaria and therefore increase physicians' awareness and prompt diagnosis and management.
Collapse
Affiliation(s)
- Tim Divine Bonghaseh
- Baptist Hospital Mutengene, Mutengene, Cameroon
- Clinical Research Education Networking and Consultancy (CRENC) Research Group, Douala, Cameroon
- Health and Human Development (2HD) Research Group, Douala, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Domin Sone M. Ekaney
- Clinical Research Education Networking and Consultancy (CRENC) Research Group, Douala, Cameroon
- Health Education and Research Organisation (HERO), Buea, Cameroon
| | | | | | - Steve Kyota
- Baptist Hospital Mutengene, Mutengene, Cameroon
| |
Collapse
|