Open AccessEmergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations
Author(s) -
Sukhen Samanta,
Sujay Samanta,
Rudrashish Haldar
Publication year - 2014
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/0019-5049.126797
Subject(s) - medicine , respiratory distress , acute kidney injury , pregnancy , intensive care medicine , pulmonary hemorrhage , malaria , cerebral malaria , anesthesia , lung , plasmodium falciparum , genetics , immunology , biology
Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block), intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa) and the role of plasmapheresis in leptospira related jaundice with renal failure.