title: [Fulminant pulmonary edema in falciparum malaria [corrected]].
abstract: METHODS
  A 54-year-old man was admitted because of intermittent fever for 2 days. Ten days earlier he had returned from Kenya. He had not taken any antimalarial drugs prophylactically.
  
  
  METHODS
  Initial blood smears showed Plasmodium falciparum in 10.4% of erythrocytes. Laboratory tests indicated hyponatremia and disseminated intravascular coagulation. Also, laboratory markers of infection and hemolysis were clearly positive and accompanied by a low-grade normocyticanaemia. Chest radiograph showed the heart size to be at the upper limit of normal and no signs of congestion, pleural effusion or inflammatory infiltrates. Sonography demonstrated hepatosplenomegaly with diffusely increased echogenicity of the liver.
  
  
  METHODS
  Falciparum malaria [corrected] with quartan fever was diagnosed and treatment with quinine and doxycycline was initiated. Despite the successful elimination of parasites and a negative fluid balance the patient died two days after admission from pulmonary edema and heart failure.
  
  
  CONCLUSIONS
  A negative fluid balance failed to prevent acute pulmonary edema in this case of severe malaria,supporting the view that fluid imbalance is not an essential feature in malaria-induced lung injury and that cytokines play and important role.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum der Johannes Gutenberg-Universität Mainz. marcm@giftinfo.uni-mainz.de
authors.forename: M-A
authors.initials: MA
authors.lastname: von Mach
authors.forename: T
authors.initials: T
authors.lastname: Hansen
authors.forename: W
authors.initials: W
authors.lastname: Ehrenthal
authors.forename: O
authors.initials: O
authors.lastname: Sauer
authors.forename: L S
authors.initials: LS
authors.lastname: Weilemann
mesh_terms: D000740:Anemia / Q000175:diagnosis / Q000209:etiology; D000962:Antimalarials / Q000627:therapeutic use; D001980:Bronchi / Q000473:pathology; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004912:Erythrocytes / Q000469:parasitology; D017809:Fatal Outcome; D006529:Hepatomegaly; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000209:etiology; D016778:Malaria, Falciparum / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy; D011803:Quinine / Q000627:therapeutic use; D013163:Splenomegaly; D014882:Water-Electrolyte Balance
chemical_list: D000962:Antimalarials; D011803:Quinine; D004318:Doxycycline
vernacular_title: Fulminantes Lungenödembei Malaria tropica.