Two cases of Plasmodium vivax Malaria with the clinical picture resembling toxic shock.
Fatal complications of Plasmodium falciparum malaria have been reported. However, complicated P. vivax malaria is rare. We observed two unusual cases of P. vivax malaria who presented with clinical pictures of toxic shock. Both showed disseminated intravascular coagulation with marked thrombocytopenia, oliguric renal failure, and pulmonary edema. Examination of initial blood smears showed a P. vivax parasitemia of 2,352/microL and 12,376/microL, respectively. The patients were treated with hydroxychloroquine and primaquine without an antibacterial agent. These cases emphasize the importance of considering the possibility of P. vivax malarial infection in patients with a clinical picture resembling toxic shock if they have a travel history to malaria-endemic areas.
Song
Joon Young
JY
Department of Internal Medicine, Korea University, Seoul, Republic of Korea.
Park
Cheong Won
CW
Jo
You Mee
YM
Kim
Jeong Yun
JY
Kim
Jeong Hyun
JH
Yoon
Hyo Joong
HJ
Kim
Chi Hoon
CH
Lim
Chae Seung
CS
Cheong
Hee Jin
HJ
Kim
Woo Joo
WJ
D000328:Adult; D000818:Animals; D003937:Diagnosis, Differential; D006801:Humans; D016780:Malaria, Vivax / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D012772:Shock, Septic / Q000175:diagnosis* / Q000469:parasitology; D014195:Travel