Imported malaria caused by Plasmodium falciparum – case report

Malaria is caused by the Plasmodium spp. which are spread through Anopheles mosquitoes. Disease is not endemic in Poland currently but can be brought from other countries, mostly from Africa and Asia. The main sign of the disease is fever with shivers repeated periodically. There is highly effective chemoprophylaxis available and treatment, which should be given quickly

A 35-year-old man have worked monthly in Nigeria since two years. He was using Malarone chemoprophylaxis, but contrary to recommendations. Patient presented to a hospital after four days of having fever in a medium-serious state. He reported three similar incidents in the past. Physical examination revealed hepatomegaly, depressive state, oliguria and diarrhoea. Lab tests showed DIC with thrombocytopenia, renal injury, liver injury, hypoalbuminemia. ECG indicated myocardial ischemia. Malaria Rapid Test and blood smear confirmed Plasmodium falciparum infection with 9,9% parasitemia. When antimalarial treatment was given, patient condition improved, but after three days in hospital he got pneumonia as a complication of malaria – antibiotic admission was committed. Moreover, quinine caused temporary deafness and serological tests revealed chronic HBV infection. After 23-days of hospitalisation the patient was discharged in a good condition. A month later patient went to follow-up and only mild anaemia was shown.

This case shown that even such severe disease like malaria can be cured well without serious complications if patient will be diagnosed quickly. Moreover patient’s experience and respecting symptoms improve prognosis. There also should be stronger emphasis on the role of chemoprophylaxis – patient did not use it properly, so it did not have to prevent development of malaria.