Acute renal failure in Plasmodium malariae infection

Area of Science:

• Infectious Diseases
• Hematology
• Transfusion Medicine

Background:

• Thalassaemia major patients often require multiple blood transfusions, increasing risks of transfusion-transmitted infections.
• Splenectomy in thalassaemia major patients can alter immune responses and disease presentation.

Observation:

• An Italian woman with thalassaemia major and splenectomy presented with prolonged, undiagnosed illness.
• The patient had received multiple blood transfusions over several months prior to diagnosis.

Findings:

• The cause of illness was identified as Plasmodium malariae, a rare form of transfusion-transmitted malaria.
• The patient experienced severe complications including acute renal failure, thrombocytopenia, and hepatic failure.

Implications:

• This case highlights the importance of considering transfusion-transmitted malaria in immunocompromised or multiply transfused patients, even with atypical presentations.
• Prompt diagnosis and treatment with chloroquine can lead to complete recovery from severe Plasmodium malariae infection.
• Screening blood donations for malaria parasites is crucial to prevent such transmissions.