Acute respiratory distress syndrome in Plasmodium vivax malaria: case report and review of the literature

BACKGROUND Among malarial parasites, Plasmodium vivax is most prevalent in humans. Recent studies have shown severe and fatal complications with Plasmodium vivax infection. We wanted to evaluate the clinical spectrum, complications and outcomes of adult subjects with Plasmodium vivax malaria mono-infection. METHODS This is a retrospective study involving 100 subjects RESULTS Males were more commonly affected. It was most prevalent in the second decade of life. Fever was present in all patients. The other common symptoms were headache, vomiting, and jaundice. The incidence of associated clinical findings were pallor (43 %), icterus (21%), hepatomegaly (39 %) and splenomegaly (27 %). Severe thrombocytopenia was seen in 18 %, hyper bilirubinaemia in 39 % of subjects. Cerebral malaria was observed in 3 %, acute kidney injury in 13 %, ARDS (Acute Respiratory Distress Syndrome) in 5 % cases, MODS (Multi Organ Dysfunction Syndrome) was seen in 3 % cases, with a mortality of 3 %. CONCLUSIONS Complications like ARDS, AKI (Acute Kidney Injury), cerebral malaria and MODS were observed in benign tertian malaria subjects in our study. Cerebral malaria, AKI, MODS, ARDS were associated with high degrees of mortality. KEYWORDS Plasmodium vivax, ARDS (Acute Respiratory Distress Syndrome), Cerebral Malaria, AKI (Acute Kidney Injury), MODS (Multiorgan Dysfunction Syndrome)

Download Full-text

Acute respiratory distress syndrome in a case of Plasmodium vivax malaria

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210855 ◽

2021 ◽

Vol 8 (3) ◽

pp. 1515

Author(s):

Atiullah Malik ◽

Yadav Ponvijaya ◽

Kshithija Sajjan ◽

Chirag Gurbani

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Plasmodium Vivax ◽

Vivax Malaria ◽

Distress Syndrome ◽

Late Complication ◽

High Grade Fever ◽

Arterial Blood ◽

Plasmodium Vivax Malaria

Acute respiratory distress syndrome (ARDS) is a life threatening complication of many infectious diseases like malaria, H1N1, bacterial pneumonia, and leptospira. Malaria is an important treatable cause of ARDS. ARDS can develop either at initial presentation or after initiation of treatment when the parasitaemia is falling and patient is improving. 58 year old female presented with high grade fever and breathlessness since 5 days. Arterial blood gas (ABG) on admission showed type 1 respiratory failure and chest X-ray was suggestive of ARDS. Thus patient was shifted to intensive care unit and was put on non-invasive ventilation. PBS was positive for Plasmodium vivax malaria and patient was started on antimalarial drugs. Considering the epidemic of H1N1 swab was sent for polymerase chain reaction (PCR) which turned out to be negative. Thus antimalarial and supportive treatment for ARDS was continued. Patient was discharged on day 11 and started on tablet primaquine to prevent relapse. ARDS is a hard to predict late complication of severe malaria. ARDS in malaria is a disease with high mortality. Early diagnosis and institution of specific antimalarial treatment along with assisted ventilation can be life-saving.

Download Full-text