Ultrasound as a Tool in Predicting the Severity of Plasmodium Falciparum Malaria
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 3
Abstract
Abstract: The value of ultrasound as an adjunct for diagnosis and monitoring malaria was investigated. In all, 82 pediatric patients (male/female 53/29; age 6m–18 years) with malaria underwent a standardised targeted ultrasound examinations including measurement of optic nerve sheath diameter, color transcranial Doppler insonation of the cerebral vasculature, cardiac ultrasound, and abdominal ultrasound. In 34 out of the total patients, ultrasonography was repeated 21 days later. Amongst the 82 patients tested by ultrasound, almost 92% had splenomegaly, of which 56% had clinically palpable spleen. This brings us to our notice that spleen palpation is highly inferior as compared to ultrasound examination in case of splenomegaly. Hepatomegaly was seen in 7 out of the 34 cases (20.5%) which was subsequently higher as compared to those recorded on the day of admission. among 42 malaria patients without a diagnosis of cerebral malaria, eleven patients had increased and two patient had borderline increased Optic nerve sheath diameter. The association between increased ONSD and clinical diagnosis of cerebral malaria was highly significant (p .003, two-tailed Fisher’s ex- act test). Of particular interest, two patients who presented with an increased ONSD showed normalization of the ONSD after 24 hrs of antimalarial therapy. Cardiac ultrasound examinations in our study did not show features to suggest either myocardial dysfunction or pulmonary hypertension, even among those with severe LA and respiratory distress. Out of all the transcranial examinations none of the patient revealed a TAMMV more than 200 cm/sec. Only 2 patients had a borderline velocity that ranges between 170 to 200 cm/sec. Our initial findings suggest that a standardized portable ultrasound examination in children with malaria has the potential to become a noninvasive tool in the assessment of severe malaria syndromes. Keywords:Falciparum, Splenomegaly, optic nerve sheath diameter, ultrasound, malaria, transcranial, cardiac ultrasound, cerebral malaria
Authors and Affiliations
Sunny Mishra, Ekta Desai, Mona Shastri, Nipa Patidar, Nehal Diwanji
Keywords
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