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Am. J. Trop. Med. Hyg., 76(4), 2007, pp. 648-654
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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CASE REPORT


DISSEMINATED INTRAVASCULAR COAGULATION COMPLICATED BY PERIPHERAL GANGRENE IN A RHESUS MACAQUE (MACACA MULATTA) EXPERIMENTALLY INFECTED WITH PLASMODIUM COATNEYI

ALBERTO MORENO*, ANAPATRICIA GARCÍA, MÓNICA CABRERA-MORA, ELIZABETH STROBERT, AND MARY R. GALINSKI
Emory Vaccine Center and Yerkes National Primate Research Center, Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia

 

ABSTRACT

We report the first case of disseminated intravascular coagulation (DIC) complicated by peripheral gangrene induced by Plasmodium coatneyi in rhesus monkeys. Ten days after experimental challenge, numerous petechiae were noted over the trunk and extremities, with polychromasia, severe anemia, thrombocytopenia, and moderate parasitemia. These changes were accompanied by elevated serum activity of blood urea nitrogen, creatinine, transaminases, and creatinine phosphokinase. The animal received intravenous fluid support, artemether, and blood transfusion. Three days after treatment, the platelet counts returned to normal, and parasitemia was abated. However, several areas of skin discoloration with gangrenous tissue in the hands and the tail were observed. Coagulation profile showed elevated D-dimers and elevated levels of fibrinogen/fibrin degradation products with low levels of protein S functional activity. DIC with peripheral gangrene is very rare in Plasmodium-infected individuals. Our results indicate that the experimental model of P. coatneyi infection of rhesus monkeys is important for studies of malarial anemia and coagulopathy.

Received October 9, 2006. Accepted for publication December 26, 2006.

Acknowledgments: The authors thank Esmeralda V-S Meyer for critical review of the manuscript.

Financial support: This research was supported by NIH/NHLBI Grant 1P01 HL078826-01 and the Yerkes National Primate Research Center Base Grant RR00165 awarded by the National Center for Research Resources of the National Institutes of Health.

* Address correspondence to Alberto Moreno, Emory Vaccine Center, Yerkes National Primate Research Center and Division of Infectious Diseases, Department of Medicine, Emory University, 954 Gatewood Rd., Atlanta, GA 30329. E-mail: amoreno{at}rmy.emory.edu

Authors’ addresses: Alberto Moreno and Mary R. Galinski, Emory Vaccine Center, Yerkes National Primate Research Center and Division of Infectious Diseases, Department of Medicine, Emory University, 954 Gatewood Rd., Atlanta, GA 30329. Anapatricia García and Elizabeth Strobert, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd., Atlanta, GA 30329. Mónica Cabrera-Mora, Emory Vaccine Center, and Yerkes National Primate Research Center Emory University, 954 Gatewood Rd., Atlanta, GA 30329.

Reprint requests: Alberto Moreno, Emory Vaccine Center, Yerkes National Primate Research Center and Division of Infectious Diseases, Department of Medicine, Emory University, 954 Gatewood Rd., Atlanta, GA 30329. E-mail: amoreno{at}rmy.emory.edu.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.