Acute myocardial infarction associated with severe Plasmodium vivax malaria.

Malaria is still a major public health problem, even after many preventive strategies. Plasmodium vivax is also a major health concern now due to the addition of new unusual manifestations day by day in its clinical profile. Herewith, we report a case of a 15-yr-old male of severe P. vivax malaria (complicated with thrombocytopenia, hepatitis, acute lung injury, and shock), who developed chest pain. Later, he was confirmed to have acute myocardial infarction based on electrocardiography, cardiac enzymes, and echocardiography. PubMed and Google-based literature search found that it was the first confirmed case of this type. Fortunately, timely diagnosis and appropriate management saved his life.

Splenic Infarction in Plasmodium vivax Infection in South Korea.

Splenic infarction caused by malaria can be fatal, but its incidence and clinical presentation are not well-known. Thus, we investigated the prevalence and characteristics of splenic complications in patients with vivax malaria from 2005 to 2017 in a university hospital. Among 273 patients who were diagnosed with Plasmodium vivax infection by blood smear, 92 underwent abdominal computed tomography or ultrasonography. Twelve patients had splenic infarction. All patients with splenic infarction recovered after treatment with antimalarial drugs, without surgery and intervention. Although anemia and prolonged fever may be risk factors for splenic infarction, the incidence of these events was insufficient for a detailed analysis.

A case of vivax malaria complicated by adult respiratory distress syndrome and successful management with extracorporeal membrane oxygenation.

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.

Multiple splenic infarcts in acute Plasmodium vivax malaria: a rare case report.

In tropical countries like India, malaria has been one of the most common parasitic illnesses leading to frequent hospitalization and causing major economic burden among the masses. Although Plasmodium vivax infection is considered to be benign, in contrast to Plasmodium falciparum infection which is notorious for its severe splenic complications can occur frequently. Splenomegaly tends not to receive special attention, as it is not usually accompanied by any symptoms and can be gradually resolved via standard antimalarial therapy. Splenic infarction, although rarely attributable to malaria in an endemic region with high parasitemia, can be a rare presentation of this disease entity.

Abdominal computed tomography findings of malaria infection with Plasmodium vivax.

Abdominal computed tomography (CT) findings of malaria are not well-known even though malaria is a serious infectious disease. To identify abdominal CT findings, we selected 34 of 405 patients who had a positive peripheral blood smear for Plasmodium vivax and had underwent abdominal CT as the malaria group. We also selected 80 patients who had fever and a negative peripheral blood smear as the control group and 120 healthy people as the normal group. We reviewed and analyzed their medical records and CT findings retrospectively. The mean spleen and liver length were significantly larger in the malaria group and the incidence of splenomegaly, splenic focal low attenuation, and spontaneous splenic rupture were much higher in the malaria group (P < 0.05). Although abdominal CT is not an indispensable tool for diagnosis, these CT findings will help in the diagnosis of malaria in patients with fever.

CT findings of malarial spleen.

Malaria is one of the most frequent causes of fever among travellers to tropical countries. We report the CT imaging findings of poor contrast enhancement of the spleen on arterial phase in a case of malaria presenting as splenomegaly. To the best of our knowledge, this is the first report of malarial spleen diagnosed by these CT results.