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Falciparum malaria with acute liver failure

A Srivastava1, A Khanduri, S Lakhtakia

  • 1Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|July 1, 1996
PubMed
Summary

Falciparum malaria can mimic severe liver failure with jaundice and altered consciousness. Early diagnosis through blood tests and prompt treatment are crucial for survival in malaria-endemic regions.

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Area of Science:

  • Infectious Diseases
  • Hepatology
  • Critical Care Medicine

Background:

  • Falciparum malaria can present with severe symptoms including encephalopathy and jaundice.
  • These symptoms can mimic fulminant hepatic failure, posing a diagnostic challenge.

Purpose of the Study:

  • To describe the clinical presentation and outcomes of falciparum malaria mimicking hepatic failure.
  • To highlight key differentiating features for early diagnosis and management.

Main Methods:

  • Retrospective analysis of seven male patients with acute falciparum malaria.
  • Clinical assessment, laboratory investigations (liver function, renal function, coagulation), and post-mortem liver biopsy were performed.

Main Results:

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  • Patients presented with fever, jaundice, altered sensorium, and oliguria.
  • Key findings included disproportionate anemia, azotaemia, and only mildly elevated liver enzymes.
  • Three patients recovered with supportive care and quinine; four succumbed to the disease.

    • Conclusions:

    • Falciparum malaria presenting as hepatic failure requires high clinical suspicion in endemic areas.
    • Differentiating features include disproportionate anemia, azotaemia, and mild liver enzyme elevation.
    • Peripheral blood examination and early specific therapy are vital for improving outcomes.