Chloroquine resistance vivax malaria in an infant: a report from India.

摘要

Zaki SA has pointed out a very valuable point of rarity of thrombocytopenia in vivax malaria. However, thrombocytopenia has been found in 3.6% of adult patients with P. vivax from India and in 2004 during the rainy season, we had six children who presented with fever and thrombocytopenia due to vivax malaria. Thrombocytopenia seen in complicated falciparum malaria is due to disseminated intravas-cular coagulation along with platelet endothelial activation but the one seen in uncomplicated malaria like P. vivax has multifactorial etiology. Few postulated mechanisms are macrophage activation leading to platelet destruction, increased levels of cytokines, immunological destruction due to antiplatelet IgG, oxidative stress, shortened platelet life span in peripheral blood and sequestration in nonsplenic areas and partly due to pseudothrombo-cytopenia due to clumping of platelets