Abstract

BASTIDAS GOYES, Alirio R; BENAVIDES, Mateo; ORTEGON, Maira  and  PROANOS JURADO, Nadia Juliana. Differences between clinical and paraclinical symptoms at admission to the emergency department of colombian military patients with severe and non-severe malaria. Acta Med Colomb [online]. 2015, vol.40, n.3, pp.202-208. ISSN 0120-2448.

Background: in recent years the recognition of clinical manifestations that occur with patients who develop severe malaria has raised interest, and the military population is susceptible of acquiring the infection with the development of complications associated with delayed recognition of its clinical manifestations. Materials and Methods: A retrospective analysis of a cohort of patients with malaria treated at a reference military hospital and development of complications according to WHO criteria during hospital observation in patients over 18 years was conducted; demographic, clinical, physical examination, paraclinical and clinical management results variables were studied. Data were analyzed in SPSS statistical progam. Results: 533 records were analyzed; differences found at hospital admission were dyspnea42.2% in severe malaria vs.16.88% in uncomplicated malaria (p <0.001), vomiting 65.6% insevere malaria vs. 7% in uncomplicated malaria (p = 0.002), history of malaria 30% in severe malaria vs. 44% in uncomplicated malaria (p = 0.006), respiratory rate 20.62 breaths/min (5.2) in severe malaria vs. 19.62 (5.2) breaths/min in uncomplicated malaria. Glasgow <15.8% in severe malaria vs. 0.4% in uncomplicated malaria, Hgb 11.06 g/dL (3.25) in severe malaria vs. 13.62g/dL (2.16) in uncomplicated malaria (p<0,001), hematocrit 33.48 (8.15) in severe malaria vs.39.70% (6.68)% in uncomplicated malaria (p <0.001), leukocytes 7390 (5601) cells/mL in severe malaria vs. 6319 (4862) cells/mL in uncomplicated malaria (p = 0.027), total bilirubin 6 (7.55)mg/dL in severe malaria vs. 2.6 (2.55) mg/dL in uncomplicated malaria, creatinine 1.98 (3.61)mg/dL in severe malaria vs. 1.03 (0.22) mg/dL in uncomplicated malaria (p = 0.029), glucose 95.09 (21.96) mg/dL vs. 103 (22.06) mg/dL (p = 0.001), P. falciparum 45.6% in severe malaria vs. 28.3% in uncomplicated malaria (p = 0.047). Conclusions: The behavior of malaria in military population is similar to that in the general population; however, the history of malaria, clinical and laboratory features may be useful for prediction of complications; further studies are needed to confirm these findings. (Acta Med Colomb2015; 40: 202-208).

Keywords : malaria; plasmodium; P. falciparum; P. vivax; militares; malaria aguda.

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