Korean J Parasitol.  2013 Oct;51(5):551-555.

A Case of Vivax Malaria Complicated by Adult Respiratory Distress Syndrome and Successful Management with Extracorporeal Membrane Oxygenation

• Lee HJ
• Baek JH
• Chae MH
• Joo H
• Lee JS
• Chung MH
• Park YK
• Kim JT

Abstract

Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

Keyword

Plasmodium vivax; vivax malaria; case report; shock; acute kidney injury; adult respiratory distress syndrome (ARDS); extracorporeal membrane oxygenation (ECMO)

MeSH Terms

Acute Kidney Injury
Anoxia
Antimalarials/*administration & dosage
Extracorporeal Membrane Oxygenation
Humans
Lung/radiography
Malaria, Vivax/*complications/diagnosis/radiography/therapy
Male
Middle Aged
Multiple Organ Failure
Plasmodium vivax/*isolation & purification
Republic of Korea
Respiratory Distress Syndrome, Adult/*complications/radiography/therapy
Treatment Outcome
Antimalarials