Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations

• Published in: Indian journal of anaesthesia Vol. 58; no. 1; pp. 55 - 58
• Main Authors: Samanta, Sukhen, Samanta, Sujay, Haldar, Rudrashish
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-01-2014; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Anesthesia; Care and treatment; Case Report; Case studies; Cesarean section; Diagnosis; Fever; Glucose; Hepatitis; Intensive care; Intrapulmonary factor VIIa; Leptospirosis; Malaria; malaria-leptospira co-infection; Methods; Mortality; Patient outcomes; plasmapheresis; Pregnancy; Pregnancy, Complications of; Respiratory distress syndrome; Thrombosis; transverse abdominis plane block; Tropical diseases; Ultrasonic imaging; Intrapulmonary factor VIIa; malaria-leptospira co-infection; plasmapheresis; transverse abdominis plane block
• ISSN: 0019-5049; 0976-2817
• DOI: 10.4103/0019-5049.126797

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.