{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:24:30Z","timestamp":1730870670429,"version":"3.28.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2024,4]]},"abstract":"Zusammenfassung<\/jats:title>\n Anamnese\u2002Eine 42-j\u00e4hrige Patientin stellte sich wegen seit 2\u00a0Tagen bestehendem starkem Erbrechen, Durchfall, Fieber und Sch\u00fcttelfrost vor. Zwei Wochen zuvor war die Patientin von einer Safari aus Tansania zur\u00fcckgekehrt. Eine Chemoprophylaxe gegen Malaria hatte sie nicht eingenommen.<\/jats:p>\n Untersuchungen und Diagnose\u2002Der Nachweis von Plasmodium falciparum f\u00fchrte zur Diagnose einer Malaria tropica. Das Blutbild zeigte eine Thrombozytopenie, die Sonografie eine Splenomegalie. Die Kriterien f\u00fcr eine komplizierte Malaria waren nicht erf\u00fcllt.<\/jats:p>\n Therapie und Verlauf\u2002Die Patientin erhielt zun\u00e4chst Atovaquon\/Proguanil oral. Die Tabletten wurden nach Einnahme wiederholt erbrochen. Daher wurde die Therapie auf Artesunat i.\u200av. umgestellt und die Patientin wurde auf der Intensivstation \u00fcberwacht. Innerhalb von 22 Stunden sank die Parasit\u00e4mie von 2,8\u200a% auf 1,0\u200a%. Die Therapie konnte nach 3\u00a0Tagen Artesunat i.\u200av. mit Atovaquon\/Proguanil oral zu Ende gef\u00fchrt werden und die Beschwerden klangen ab.<\/jats:p>\n Folgerung\u2002Ausgepr\u00e4gte gastrointestinale Symptome k\u00f6nnen auf ein drohendes Organversagen hinweisen. Eine an sich unkomplizierte Malaria mit anhaltendem Erbrechen sollte daher \u2013 wie die komplizierte Malaria \u2013 intraven\u00f6s behandelt werden, und die Patienten sollten intensiv \u00fcberwacht werden. Anhaltendes Erbrechen bei Malaria tropica ist als m\u00f6gliches Kriterium f\u00fcr eine komplizierte Malaria anzusehen.<\/jats:p>","DOI":"10.1055\/a-2256-6589","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T22:38:47Z","timestamp":1712097527000},"page":"454-457","source":"Crossref","is-referenced-by-count":0,"title":["Gastrointestinale Symptome als Ausdruck einer komplizierten Malaria tropica"],"prefix":"10.1055","volume":"149","author":[{"given":"Matthias","family":"K\u00e4stner","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Tropenmedizin und Infektionskrankheiten mit Sektion Nephrologie der Universit\u00e4tsmedizin Rostock"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph Josef","family":"Hemmer","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Tropenmedizin und Infektionskrankheiten mit Sektion Nephrologie der Universit\u00e4tsmedizin Rostock"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emil Christian","family":"Reisinger","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Tropenmedizin und Infektionskrankheiten mit Sektion Nephrologie der Universit\u00e4tsmedizin Rostock"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","DOI":"10.30875\/6c551ba0-en","volume-title":"World malaria report 2021","author":"World Health Organization","year":"2021"},{"issue":"06","key":"ref3","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1186\/s13054-014-0642-6","article-title":"The fluid management of adults with severe malaria","volume":"18","author":"J Hanson","year":"2014","journal-title":"Crit Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.tmaid.2014.04.014","article-title":"Risk factors associated with malaria deaths in travellers: A literature review","volume":"13","author":"B L\u00fcthi","year":"2015","journal-title":"Travel Med Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"589379","DOI":"10.3389\/fmed.2020.589379","article-title":"Does Malaria Cause Diarrhoea? 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