Cardiac complication after experimental human malaria infection: a case report

Area of Science:

• Clinical immunology
• Infectious diseases
• Cardiology

Background:

• A Phase I/IIa clinical trial evaluated the safety and efficacy of the candidate malaria vaccine PfLSA-3-rec, adjuvanted with aluminium hydroxide.
• Healthy volunteers received the vaccine followed by experimental infection with Plasmodium falciparum.

Observation:

• A 20-year-old female volunteer developed retrosternal chest pain 16 days post-infection, 5 days after completing artemether/lumefantrine treatment.
• The patient was diagnosed with acute coronary syndrome and recovered quickly with appropriate medical management.

Findings:

• The acute coronary syndrome event occurred temporally close to experimental malaria infection and antimalarial treatment.
• While the exact cause remains undetermined, malaria infection is considered the most probable trigger, despite its rarity in millions of annual malaria cases.
• Myocarditis was also considered, but the precise nature and pathophysiology of the cardiac event are unclear.

Implications:

• This case highlights a rare potential adverse event following experimental malaria infection, prompting further investigation into cardiac complications.
• Understanding the pathophysiology is crucial for vaccine development and patient safety in malaria research.
• The findings underscore the need for vigilance regarding unexpected clinical events in vaccine trials and infectious disease research.