TYPES OF MALARIA: COMPLICATED FALCIPARUM MALARIA

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Case definition: P. falciparum asexual parasitemia in the peripheral blood smear or by RDT. Symptomatic malaria without signs of severity or evidence of vital organ dysfunction. 

Case scenario:

                      A 45-year-old man is brought into your clinic with a sudden high fever, headache, vomiting, diarrhea, yellow sclera, and dark urine. He is drowsy but is able to answer your questions. On physical examination, his temperature is 103 Fahrenheit, pulse is 110/minute, respiratory rate is 36/min and he is jaundiced. There is some tenderness over the liver, but the abdomen is otherwise soft and non-tender.

Lab tests accompanying him is as follows: Hb 9.8 gm/dl, W.B.C: 5,500/cm, platelets: 40,000/cm, total bilirubin: 5.8 mg/dl, ALT:65 I.U, Blood urea 65 mg/dl, S.creatinine: 4.5 mg/dl, MP shows trophozoites of P.falciparum.

Warning signs:

  1. Hyperpyrexia
  2. Prostration
  3. Impaired consciousness
  4. Respiratory disease
  5. Multiple convulsions
  6. Circulatory collapse
  7. Pulmonary edema
  8. Abnormal bleeding
  9. Jaundice
  10. Hyperglobinuria

Laboratory tests:

  1. Severe anemia
  2. Hypoglycemia
  3. Acidosis
  4. Renal impairment
  5. hyperlactatemia
  6. Hyperparasitemia

 

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