Hyperglycemia in Severe Falciparum Malaria: A Case Report

Occasionally, malaria may present with unusual signs and symptoms. We report a case of an uncommon presentation ofPlasmodium falciparuminfection in a 59-year-old Ethiopian immigrant, which initially presented with hyperglycaemia and multiple organ dysfunction syndrome (MODS). Reports of unusual presentations of malaria are few and cases of severe malaria with hyperglycaemia are rarely described. As hyperglycaemia is associated to most severe malaria and high mortality, our aim is to catch the attention of the physicians on this entity.

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Identifying the Components of Acidosis in Patients With Severe Plasmodium falciparum Malaria Using Metabolomics

The Journal of Infectious Diseases ◽

10.1093/infdis/jiy727 ◽

2018 ◽

Vol 219 (11) ◽

pp. 1766-1776 ◽

Cited By ~ 11

Author(s):

Stije J Leopold ◽

Aniruddha Ghose ◽

Erik L Allman ◽

Hugh W F Kingston ◽

Amir Hossain ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Severe Malaria ◽

Falciparum Malaria ◽

Intestinal Barrier ◽

Plasmodium Falciparum Malaria ◽

Intestinal Barrier Function ◽

Life Threatening ◽

Plasma Marker ◽

Severe Falciparum Malaria

AbstractBackgroundAcidosis in severe Plasmodium falciparum malaria is associated with high mortality, yet the pathogenesis remains incompletely understood. The aim of this study was to determine the nature and source of metabolic acids contributing to acidosis in patients with severe falciparum malaria.MethodsA prospective observational study was conducted to characterize circulating acids in adults with P. falciparum malaria (n = 107) and healthy controls (n = 45) from Bangladesh using high-resolution liquid chromatography–mass spectrometry metabolomics. Additional in vitro P. falciparum culture studies were performed to determine if parasites release the acids detected in plasma from patients with severe malaria acidosis.ResultsWe identified previously unmeasured plasma acids strongly associated with acidosis in severe malaria. Metabolomic analysis of P. falciparum parasites in vitro showed no evidence that these acids are released by the parasite during its life cycle. Instead, 10 of the plasma acids could be mapped to a gut microbial origin. Patients with malaria had low L-citrulline levels, a plasma marker indicating reduced gut barrier integrity. Longitudinal data showed the clearance of these newly identified acids was delayed in fatal cases.ConclusionsThese data suggest that a compromise in intestinal barrier function may contribute significantly to the pathogenesis of life-threatening acidosis in severe falciparum malaria.Clinical Trials RegistrationNCT02451904.

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Evidence of IL-17, IP-10, and IL-10 involvement in multiple-organ dysfunction and IL-17 pathway in acute renal failure associated to Plasmodium falciparum malaria

Journal of Translational Medicine ◽

10.1186/s12967-015-0731-6 ◽

2015 ◽

Vol 13 (1) ◽

Cited By ~ 13

Author(s):

Fabien Herbert ◽

Nicolas Tchitchek ◽

Devendra Bansal ◽

Julien Jacques ◽

Sulabha Pathak ◽

...

Keyword(s):

Renal Failure ◽

Plasmodium Falciparum ◽

Acute Renal Failure ◽

Falciparum Malaria ◽

Organ Dysfunction ◽

Plasmodium Falciparum Malaria ◽

Multiple Organ ◽

Multiple Organ Dysfunction

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Faculty of 1000 evaluation for Endoglin in African children with Plasmodium falciparum malaria: a novel player in severe malaria pathogenesis?

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.1691966.1198069 ◽

2010 ◽

Author(s):

Charles Newton ◽

Samson Gwer

Keyword(s):

Plasmodium Falciparum ◽

Severe Malaria ◽

Falciparum Malaria ◽

Plasmodium Falciparum Malaria ◽

African Children

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Predictors of treatment failures of plasmodium falciparum malaria in Vietnam: a 4-year single‐centre retrospective study

Malaria Journal ◽

10.1186/s12936-021-03720-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Minh Cuong Duong ◽

Oanh Kieu Nguyet Pham ◽

Phong Thanh Nguyen ◽

Van Vinh Chau Nguyen ◽

Phu Hoan Nguyen

Keyword(s):

Plasmodium Falciparum ◽

Treatment Failure ◽

Severe Malaria ◽

Falciparum Malaria ◽

Control Strategies ◽

Artemisinin Resistance ◽

Plasmodium Falciparum Malaria ◽

Molecular Technique ◽

Drug Resistant ◽

Public Health Burden

Abstract Background Drug-resistant falciparum malaria is an increasing public health burden. This study examined the magnitude of Plasmodium falciparum infection and the patterns and predictors of treatment failure in Vietnam. Methods Medical records of all 443 patients with malaria infection admitted to the Hospital for Tropical Diseases between January 2015 and December 2018 were used to extract information on demographics, risk factors, symptoms, laboratory tests, treatment, and outcome. Results More than half (59.8%, 265/443, CI 55.1–64.4%) of patients acquired Plasmodium falciparum infection of whom 21.9% (58/265, CI 17.1–27.4%) had severe malaria, while 7.2% (19/265, CI 4.6–10.9%) and 19.2% (51/265, CI 14.7–24.5%) developed early treatment failure (ETF) and late treatment failure (LTF) respectively. Among 58 patients with severe malaria, 14 (24.1%) acquired infection in regions where artemisinin resistance has been documented including Binh Phuoc (11 patients), Dak Nong (2 patients) and Gia Lai (1 patient). Under treatment with intravenous artesunate, the median (IQR) parasite half-life of 11 patients coming from Binh Phuoc was 3 h (2.3 to 8.3 h), two patients coming from Dak Nong was 2.8 and 5.7 h, and a patient coming from Gia Lai was 6.5 h. Most patients (98.5%, 261/265) recovered completely. Four patients with severe malaria died. Severe malaria was statistically associated with receiving treatment at previous hospitals (P < 0.001), hepatomegaly (P < 0.001) and number of inpatient days (P < 0.001). Having severe malaria was a predictor of ETF (AOR 6.96, CI 2.55–19.02, P < 0.001). No predictor of LTF was identified. Conclusions Plasmodium falciparum remains the prevalent malaria parasite. Despite low mortality rate, severe malaria is not rare and is a significant predictor of ETF. To reduce the risk for ETF, studies are needed to examine the effectiveness of combination therapy including parenteral artesunate and a parenteral partner drug for severe malaria. The study alerts the possibility of drug-resistant malaria in Africa and other areas in Vietnam, which are known as non-endemic areas of anti-malarial drug resistance. A more comprehensive study using molecular technique in these regions is required to completely understand the magnitude of drug-resistant malaria and to design appropriate control strategies.

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Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010001 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1

Author(s):

Boushab Mohamed Boushab ◽

Mohamed Salem Ould Ahmedou Salem ◽

Ali Ould Mohamed Salem Boukhary ◽

Philippe Parola ◽

Leonardo Basco

Keyword(s):

Renal Failure ◽

Respiratory Distress ◽

Severe Malaria ◽

Falciparum Malaria ◽

Clinical Features ◽

Signs And Symptoms ◽

Plasmodium Falciparum Malaria ◽

Severe Anaemia ◽

World Health ◽

Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

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