Korean J Infect Dis.  2001 Oct;33(5):354-359.

Two Cases of Severe Plasmodium falciparum Malaria Complicated with Acute Respiratory Distress Syndrome

• Choi SM
• Lee YJ
• Park SH
• Koh MB
• Kim SI
• Kim YR
• Kim YK
• Kang MW

Abstract

Malaria remains one of the most important infectious diseases in the world. For those not immuned to malaria, delayed diagnosis and treatment have been associated with an increase in morbidity and mortality, and development of severe complications. Pulmonary edema is one of the serious complications in falciparum malaria. It usually occurs in association with cerebral malaria, acute renal failure, high parasitemia, and delayed antimalarial treatment, as well as treatment-related side effects. We report two cases of severe falciparum malaria with rapidly developed pulmonary edema, which was not combined with cardiac decompensation or fluid overload. Both patients had a history of traveling to foreign countries, Thailand and Ghana, which chloroquine-resistant malaria is distributed. The first patient who developed hyperbilirubinemia, hypoglycemia, thrombocytopenia, decreased mentality, multi-organ failure, and pulmonary edema with acute respitatory distress syndrome, was treated with quinine, doxycycline, hemodialysis, and mechanical ventilation. The patient was recovered with a sequela of restrictive lung change. The second patient also developed anemia, thrombocytopenia, mental confusion, and pulmonary edema with aucte lung injury. Through the treatment of quinine, diuretics, and high concentration of oxygen via facial mask, the patient was successfully recovered without any sequela.

Keyword

Malaria; Falciparum; Pulmonary edema; Acute Respiratory distress syndrome

MeSH Terms

Acute Kidney Injury
Anemia
Communicable Diseases
Delayed Diagnosis
Diuretics
Doxycycline
Ghana
Humans
Hyperbilirubinemia
Hypoglycemia
Lung
Lung Injury
Malaria
Malaria, Cerebral
Malaria, Falciparum*
Masks
Mortality
Oxygen
Parasitemia
Plasmodium falciparum*
Plasmodium*
Pulmonary Edema
Quinine
Renal Dialysis
Respiration, Artificial
Respiratory Distress Syndrome, Adult*
Thailand
Thrombocytopenia
Diuretics
Doxycycline
Oxygen
Quinine