title: Acute respiratory distress syndrome due to vivax malaria: case report and literature review.
abstract: Severe pulmonary involvement in malaria has been frequently reported in cases of Plasmodium falciparum infection, but rarely in vivax malaria. Among the 11 previous cases of vivax-related severe respiratory involvement described in the literature, all except one developed it after the beginning of anti-malarial treatment; these appear to correspond to an exacerbation of the inflammatory response. We report the case of a 43-year-old Brazilian woman living in a malaria-endemic area, who presented acute respiratory distress syndrome (ARDS) caused by P. vivax before starting anti-malarial treatment. The diagnosis was made based on microscopic methods. A negative rapid immunochromatographic assay, based on the detection of Histidine Rich Protein-2 (HRP-2) of P. falciparum, indicated that falciparum malaria was unlikely. After specific anti-plasmodial therapy and intensive supportive care, the patient was discharged from the hospital. We conclude that vivax malaria-associated ARDS can develop before anti-malarial therapy.
authors.affiliation: Teaching and Research Israelit Institute Albert Einstein, Albert Einstein Hospital, Avenida Albert Einstein 627, São Paulo, SP, Brazil. andre@lomar.med.br
authors.forename: André V
authors.initials: AV
authors.lastname: Lomar
authors.forename: José E
authors.initials: JE
authors.lastname: Vidal
authors.forename: Frederico P
authors.initials: FP
authors.lastname: Lomar
authors.forename: Carmen Valente
authors.initials: CV
authors.lastname: Barbas
authors.forename: Gustavo Janot
authors.initials: GJ
authors.lastname: de Matos
authors.forename: Marcos
authors.initials: M
authors.lastname: Boulos
mesh_terms: D000328:Adult; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008288:Malaria / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000175:diagnosis; D016780:Malaria, Vivax / Q000150:complications* / Q000175:diagnosis*; D010963:Plasmodium falciparum; D010966:Plasmodium vivax; D012128:Respiratory Distress Syndrome / Q000209:etiology*