Autopsy discoveries of death from malaria

Ritesh G. Menezes, Sadip Pant, Magdy A. Kharoshah, Subramanian Senthilkumaran, M. Arun, K. R. Nagesh, Nishanth B. Bhat, D. R. Mahadeshwara Prasad, Raj Kumar Karki, S. H. Subba, Abul Fazil

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

Malaria inflicts a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria on autopsy. The aim of this study is to review autopsy diagnosed malaria related deaths in the literature with due stress to its biologic and forensic aspects. A meticulous literature search was performed for " sudden malaria death" , " malaria death postmortem diagnosis" and " unexplained death malaria" across PubMed, SCOPUS, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, Ovid-MEDLINE and Google Scholar. All the literature was thoroughly reviewed and analyzed with reference to the type of study, location, travel history, age, gender, circumstance of death, method of diagnosis, species involved, chemoprophylaxis usage and take home message from the particular study. Plasmodium falciparum was responsible in most of the cases. The symptoms mimicked influenza in most of the case reports. Travel to endemic areas was common to most of the victims. The travelers were from all over the world including USA, France, Switzerland, Spain, Portugal, Germany and Asia (China and Japan). Vascular congestion with the presence of malarial pigment laden RBCs in capillaries of various organs was the major histopathology finding. Such lesions were found in the brains of all subjects (100%), liver of 78% of the cases, spleen in 67%, lungs in 56% and myocardium in 43% of the cases. Peripheral smear and rapid diagnostic test was of great aid to the autopsy in many cases. PCR was used for diagnosis as well as exclusion of possibility of co-infection with other species in case of Plasmodium knowlesi related death. The postmortem and histopathology findings in this case were similar to P. falciparum except for the fact that brain sections were negative for intracellular adhesion molecule-1. Chemoprophylaxis was not taken by the victims except for two in whom history of chloroquine based chemoprophylaxis was mentioned. Given the worldwide prevalence of the disease, increasing international travel and rapidly developing drug resistance, malaria will continue to be an important disease and should be considered in all cases of unexpected deaths particularly in malaria endemic regions or in presence of travel history to endemic regions.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
JournalLegal Medicine
Volume14
Issue number3
DOIs
Publication statusPublished - 01-05-2012

Fingerprint

Malaria
Autopsy
Chemoprevention
Plasmodium falciparum
Plasmodium knowlesi
Portugal
Chloroquine
Brain
Complementary Therapies
Sudden Death
Coinfection
Switzerland
Routine Diagnostic Tests
Drug Resistance
PubMed
MEDLINE
Spain
Human Influenza
France
Germany

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Issues, ethics and legal aspects

Cite this

Menezes, R. G., Pant, S., Kharoshah, M. A., Senthilkumaran, S., Arun, M., Nagesh, K. R., ... Fazil, A. (2012). Autopsy discoveries of death from malaria. Legal Medicine, 14(3), 111-115. https://doi.org/10.1016/j.legalmed.2012.01.007
Menezes, Ritesh G. ; Pant, Sadip ; Kharoshah, Magdy A. ; Senthilkumaran, Subramanian ; Arun, M. ; Nagesh, K. R. ; Bhat, Nishanth B. ; Mahadeshwara Prasad, D. R. ; Karki, Raj Kumar ; Subba, S. H. ; Fazil, Abul. / Autopsy discoveries of death from malaria. In: Legal Medicine. 2012 ; Vol. 14, No. 3. pp. 111-115.
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Menezes, RG, Pant, S, Kharoshah, MA, Senthilkumaran, S, Arun, M, Nagesh, KR, Bhat, NB, Mahadeshwara Prasad, DR, Karki, RK, Subba, SH & Fazil, A 2012, 'Autopsy discoveries of death from malaria', Legal Medicine, vol. 14, no. 3, pp. 111-115. https://doi.org/10.1016/j.legalmed.2012.01.007

Autopsy discoveries of death from malaria. / Menezes, Ritesh G.; Pant, Sadip; Kharoshah, Magdy A.; Senthilkumaran, Subramanian; Arun, M.; Nagesh, K. R.; Bhat, Nishanth B.; Mahadeshwara Prasad, D. R.; Karki, Raj Kumar; Subba, S. H.; Fazil, Abul.

In: Legal Medicine, Vol. 14, No. 3, 01.05.2012, p. 111-115.

Research output: Contribution to journalReview article

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AU - Menezes, Ritesh G.

AU - Pant, Sadip

AU - Kharoshah, Magdy A.

AU - Senthilkumaran, Subramanian

AU - Arun, M.

AU - Nagesh, K. R.

AU - Bhat, Nishanth B.

AU - Mahadeshwara Prasad, D. R.

AU - Karki, Raj Kumar

AU - Subba, S. H.

AU - Fazil, Abul

PY - 2012/5/1

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N2 - Malaria inflicts a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria on autopsy. The aim of this study is to review autopsy diagnosed malaria related deaths in the literature with due stress to its biologic and forensic aspects. A meticulous literature search was performed for " sudden malaria death" , " malaria death postmortem diagnosis" and " unexplained death malaria" across PubMed, SCOPUS, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, Ovid-MEDLINE and Google Scholar. All the literature was thoroughly reviewed and analyzed with reference to the type of study, location, travel history, age, gender, circumstance of death, method of diagnosis, species involved, chemoprophylaxis usage and take home message from the particular study. Plasmodium falciparum was responsible in most of the cases. The symptoms mimicked influenza in most of the case reports. Travel to endemic areas was common to most of the victims. The travelers were from all over the world including USA, France, Switzerland, Spain, Portugal, Germany and Asia (China and Japan). Vascular congestion with the presence of malarial pigment laden RBCs in capillaries of various organs was the major histopathology finding. Such lesions were found in the brains of all subjects (100%), liver of 78% of the cases, spleen in 67%, lungs in 56% and myocardium in 43% of the cases. Peripheral smear and rapid diagnostic test was of great aid to the autopsy in many cases. PCR was used for diagnosis as well as exclusion of possibility of co-infection with other species in case of Plasmodium knowlesi related death. The postmortem and histopathology findings in this case were similar to P. falciparum except for the fact that brain sections were negative for intracellular adhesion molecule-1. Chemoprophylaxis was not taken by the victims except for two in whom history of chloroquine based chemoprophylaxis was mentioned. Given the worldwide prevalence of the disease, increasing international travel and rapidly developing drug resistance, malaria will continue to be an important disease and should be considered in all cases of unexpected deaths particularly in malaria endemic regions or in presence of travel history to endemic regions.

AB - Malaria inflicts a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria on autopsy. The aim of this study is to review autopsy diagnosed malaria related deaths in the literature with due stress to its biologic and forensic aspects. A meticulous literature search was performed for " sudden malaria death" , " malaria death postmortem diagnosis" and " unexplained death malaria" across PubMed, SCOPUS, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, Ovid-MEDLINE and Google Scholar. All the literature was thoroughly reviewed and analyzed with reference to the type of study, location, travel history, age, gender, circumstance of death, method of diagnosis, species involved, chemoprophylaxis usage and take home message from the particular study. Plasmodium falciparum was responsible in most of the cases. The symptoms mimicked influenza in most of the case reports. Travel to endemic areas was common to most of the victims. The travelers were from all over the world including USA, France, Switzerland, Spain, Portugal, Germany and Asia (China and Japan). Vascular congestion with the presence of malarial pigment laden RBCs in capillaries of various organs was the major histopathology finding. Such lesions were found in the brains of all subjects (100%), liver of 78% of the cases, spleen in 67%, lungs in 56% and myocardium in 43% of the cases. Peripheral smear and rapid diagnostic test was of great aid to the autopsy in many cases. PCR was used for diagnosis as well as exclusion of possibility of co-infection with other species in case of Plasmodium knowlesi related death. The postmortem and histopathology findings in this case were similar to P. falciparum except for the fact that brain sections were negative for intracellular adhesion molecule-1. Chemoprophylaxis was not taken by the victims except for two in whom history of chloroquine based chemoprophylaxis was mentioned. Given the worldwide prevalence of the disease, increasing international travel and rapidly developing drug resistance, malaria will continue to be an important disease and should be considered in all cases of unexpected deaths particularly in malaria endemic regions or in presence of travel history to endemic regions.

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Menezes RG, Pant S, Kharoshah MA, Senthilkumaran S, Arun M, Nagesh KR et al. Autopsy discoveries of death from malaria. Legal Medicine. 2012 May 1;14(3):111-115. https://doi.org/10.1016/j.legalmed.2012.01.007