CASE PRESENTATION
ON
MALARIA
SUBMITTED BY:
A. SURESH
Pharm. D Vth year
194T1T0006
PATIENT DEMOGRAPHIC DETAILS:-
• Name :- [Link]
• Age :- 22 years
• Gender :- Male
• Dept. :- GMMW
CHIEF COMPLAINTS:-
1. K/C/O fever ( High grade fever) since 4 days.
2. Head ache since 4 days.
3. Generalised body pains since 4 days.
PAST MEDICAL HISTORY:-
NILL
PAST MEDICATION HISTORY:-
NILL
PERSONAL HISTORY:-
• Diet :- Mixed
• Appetite :- Normal
• B and B :- Regular
• Sleep :- Adequate
• Micturition :- Normal
• Occupation :- Driver
• Alcohol :- Occasional
ON EXAMINATION:-
VITALS Day 1 Day 2
1. Blood pressure 110/70 120/80
( mm of Hg )
2. Pulse rate ( BPM) 130 86
3. Temperature 105 0F 99 0F
4. Spo2 98% 98%
LABORATORY INVESTIGATIONS:
COMPLETE BLOOD
COUNT Observed value Normal value
Haemoglobin 13.7 g/dl 14 to 16 g/dl
RBC Count 4.58 mill/cumm 4.5 to 6.5 mill/cumm
Platelet count 0.44 lakhs C/cumm 1.5 to 4.5 lakhs C/cumm
Total WBC count 4,300 C/cumm 4000 to 11000 C/cumm
PCV 38.2% 40 to 54%
MCH 29.9 pg 27 to 32 pg
MCHC 35.9% 31 to 36%
RBS 134 mg/dl 70 to 140 mg/dl
LABORATORY INVESTIGATIONS
DIFFERENTIAL COUNT
Neutrophils 69% 40 to 80%
Lymphocytes 26% 20 to 45%
Monocytes 03% 02 to 10%
Eosinophils 02% 01 to 06%
Basophils 00% 00 to 02%
MALARIAL PARASITES
SPECIMEN:- Whole blood
METHOD :- Immuno chromatographic
test card method.
LABORATORY INVESTIGATIONS
RESULT :- Positive for plasmodium
vivax
LIVER FUNCTION TESTS
Serum Total bilirubin 2.8mg/dl 0.2 to 1.0 mg/dl
Serum Direct bilirubin 1.0mg/dl up to 0.2 mg/dl
Serum indirect bilirubin 1.8 mg/dl 0.5 to 0.8 mg/dl
Serum creatinine 1.2 mg/dl 0.6 to 1.4 mg/dl
Peripheral blood smear:
RBC:-
Normocytic,normochromic. Growing of trophozoites of
Haemoparasites:- [Link] seen.
URINE ANALYSIS:-
• PHYSICAL EXAMINATION:-
• Colour :- Pale yellow
• Appearance :- clear
• Reaction :- Acidic
• CHEMICAL EXAMINATION:-
• Albumin :- Nil
• Sugar :- Nil
• Phosphates :- Nil
• Bile salts :- Negative
MICROSCOPIC EXAMINATION:-
• Pus cells :- 2 to 4.
• Epithelial cells :- 2 to 4.
• RBC :- Nil
• Amorphous phosphate :- Nil
• Bacilli :- Nil.
• Crystals :- Nil
• SEROLOGY:-
• Dengue IgG :- Negative
IgM :- Negative
NS1 AG ANTIGEN :- Negative
SOAP NOTES
• SUBJECTIVE:- A male patient of age 22 years old was admitted in katya
hospital with his complaints like high grade fever, headache, generalised body
pains in general medical male ward.
• OBJECTIVE:-
• Lab investigations Observed value Normal value
• Serum total bilirubin 2.8mg/dl 0.2 to 1.0mg/dl
• Serum bilirubin ( direct). 1.0mg/dl. 0.0 to 0.2mg/dl
• Serum bilirubin ( indirect) 1.8mg/dl. 0.5 to 0.8mg/dl
• Platelet count 0.44lakhsC/cumm. 1.5 to 4.5 lakhsC/cumm
• Growing trophozoites plasmodium falciparum occasionally.
• Malarial specimen: Positive for plasmodium vivax.
• ASSESMENT:- Based on subjective and objective evidences the patient
diagnosed as Acute febrile illness of malaria vivax, mild hepatopathy and
PLANNING:-
ABOUT DRUGS:-
DRUG NAME MECHANISM OF USES SIDE EFFECTS
ACTION
1. Inj. Artesunate Artesunate is a pro drug that It is used for Pain at injection at
is rapidly converted to its the treatment of inj. Site, head ache,
active form of (DHA) severe dizziness, decrease
dihydroartemisinin. It inhibits falciparum platelet count
calcium-dependent ATPase on malaria.
endoplasmic membrane, which
disrupts protein folding.
2. Inj. used to reduce fever and Inhibits Joint pains, head
Paracetamol body pains. prostaglandin ache, dizziness,
synthesis. tiredness.
Ceftriaxone and It works by preventing the It is used to Diarrhoea
Sulbactum formation which is essential treat bacterial Increased liver
for survival of bacteria. infections. enzymes
Sulbactum is a beta Allergic reactions and
lactamase inhibitor which rashes.
reduces the resistance and
enhance the activity of
ceftriaxone against bacteria.
Pantoprazole Inhibits H+/K+ ATPase pump Decreases the Headache, diarrhoea,
and inhibits gastric acid and amount of acid gas,
basal acid secretion. produced in the Stomach pain, nausea
stomach. and vomiting,
dizziness.
DISEASE INFORMATION:-
• MALARIA :-
Malaria is the disease caused by a parasite. The parasite is
transmitted to humans through the bites of infected mosquitoes. People
who have malaria fever usually very sick, with a high fever and shaking
chills.
• TYPES OF MALARIAL PARASITES:-
1. Plasmodium falciparum
2. Plasmodium vivax
Plasmodium malariae
3. Plasmodium berghei and plasmodium ovale.
Mosquito transmission cycle:-
INCUBATION PERIOD:-
SIGNS AND SYMPTOMS:-
RISK FACTORS:-
People at increased risk of serious disease include:-
1. Young children and infants.
2. Older adults.
3. Travelers coming from areas with malaria.
4. Pregnant women and their unborn children.
COMPLICATIONS:-
5. Cerebral malaria
6. Organ failure
7. Anemia
8. Low blood sugar
DIAGNOSIS:-
1. Medical History.
2. Physical examination.
3. Peripheral blood smear.
4. Laboratory diagnosis like thin and thick
smear.
5. Rapid Diagnostic tests (RDT).
6. Polymerase chain reactions.
TREATMENT:-
• Malaria is treated with prescription drugs to kill the
parasites. The types of drugs and the length of
treatment will vary depending on types of malarial
parasites. The commonly used drugs are
1. Artesunate
2. Atremesin.
3. Chloroquinone phosphate
4. Combination of atovaquone and proguanil ( melarone)
5. Quinine sulfate with doxycycline
6. Primaquine phosphate.
CRITICAL EVALUATION:-
• Clinical condition :- Malaria fever
• Drug of choice :- Chloroquinone
phosphate
• Dose :- Appropriate
• Dosage form :- Appropriate
• Frequency :- Appropriate
• Duration :- Appropriate
• Guidelines :- WHO Guidelines
• DRUG NTERACTIONS :- Not found
PATIENT COUNSELLING:-
1. REGARDING DISEASE:-
Malaria is a disease caused by a parasite .The parasite is transmitted to humans
through the of infected mosquitoes.
2. REGARDING DISEASE:-
• Inj. Artesunate :- Acts as a antimalarial drug.
• Inj. Ceftriaxone:- used to treat bacterial infections.
• Inj. Paracetamol:- used to reduce fever
• Inj. Pantoprazole:- used to decreases acid in the stomach.
3. LIFESTYLE MODIFICATIONS:-
1. Sleeping under bed nets.
2. Clothing:- covers most of the exposed skin.
3. Apply insect repellent to all exposed skin.
4. Wash your hands carefully before taking the
food.
5. Take medications regularly as prescribed by
the physician.
6. Avoid alcohol.
REFERENCE:-
• [Link].
• [Link].
• [Link].
