Indian Journal of Vascular and Endovascular Surgery

LETTER TO THE EDITOR
Year
: 2016  |  Volume : 3  |  Issue : 3  |  Page : 112-

Gangrene and Malaria


Khichar Purnaram Shubhakaran 
 Department of Neurology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

Correspondence Address:
Dr. Khichar Purnaram Shubhakaran
Department of Neurology, Dr. S. N. Medical College, Jodhpur, Rajasthan
India




How to cite this article:
Shubhakaran KP. Gangrene and Malaria.Indian J Vasc Endovasc Surg 2016;3:112-112


How to cite this URL:
Shubhakaran KP. Gangrene and Malaria. Indian J Vasc Endovasc Surg [serial online] 2016 [cited 2020 Jul 13 ];3:112-112
Available from: http://www.indjvascsurg.org/text.asp?2016/3/3/112/186718


Full Text

I read an interesting case report of Plasmodium vivax malaria complicated by symmetrical peripheral gangrene.[1] With the reemergence of malaria, such rare but unique complications of malaria have been observed from time to time and reported mainly from India.[2],[3],[4],[5] More frequently being described in falciparum malaria, however, a few such cases or complications are also reported in P. vivax[4] and mixed [5] malaria also. Exact pathogenesis could not be ascertained.[2] Microcirculatory block due to sludging of the parasitized erythrocytes in capillaries is a well-known factor in heavy Plasmodium falciparum parasitemia. The blockage of terminal arteries/arterioles could be the important reason for the gangrene. The vascular flow in the organs is disturbed by vascular collapse, thrombosis, infarction, and similar effects brought about by clumping together of parasitized cells. All these factors slow down the circulation and cause “sludging.” In a patient presenting with dry gangrene and fever, a possibility of malaria must be kept in mind not only in endemic areas but also in nonendemic areas because of the resurgence of malaria in the last few years.[2]

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Conflicts of interest

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References

1Chatterjee K, Sen C. Symmetrical peripheral gangrene complicating vivax malaria. Indian J Vasc Endovasc Surg 2015;2:166-7.
2Kochar Shubhakaran DK, Kumawat B, Kochar SK. A patient with falciparum malaria and bilateral gangrene of the feet who developed arrhythmia/ventricular fibrillation after quinine therapy. QJM 1998;91:246.
3Arya TV, Singh SP, Singh DK. Bilateral foot gangrene occurring in falciparum malaria. JAPI 1990;38:30.
4Arora N, Gogna A, Kumar D, Puri K. Peripheral gangrene in Plasmodium vivax malaria: A rare manifestation. Trop Doct 2013;43:23-4.
5Agrawal A, Rastogi A, Tiwari D. Symmetric peripheral gangrene with mixed malaria. Indian J Pediatr 2007;74:587-8.