P. vivax malaria complicated by shock and ARDS

Area of Science:

• Infectious Diseases
• Tropical Medicine
• Clinical Microbiology

Background:

• Plasmodium vivax is a common cause of malaria globally.
• While often considered benign, severe P. vivax malaria is increasingly recognized.
• Distinguishing P. vivax from P. falciparum malaria is critical for appropriate treatment.

Observation:

• A case of severe Plasmodium vivax malaria presenting with shock and acute respiratory distress syndrome (ARDS) is described.
• The patient received oral chloroquine and primaquine for treatment.
• Polymerase chain reaction (PCR) confirmed P. vivax DNA and ruled out P. falciparum DNA.

Findings:

• Plasmodium vivax can lead to life-threatening complications, including shock and ARDS.
• Effective treatment with standard antimalarial drugs (chloroquine and primaquine) was observed.
• PCR testing demonstrated high sensitivity and specificity for P. vivax detection and exclusion of mixed infections.

Implications:

• Clinicians should maintain a high index of suspicion for severe P. vivax malaria, even in non-endemic areas.
• PCR analysis is recommended for definitive diagnosis, especially when mixed infections are suspected.
• Early and accurate diagnosis of P. vivax malaria is essential for timely and effective management to prevent severe outcomes.