Transfusion-related Plasmodium ovale malaria complicated by acute respiratory distress syndrome (ARDS) in a non-endemic country.
46year old female presented with a one week history of high grade fever, chills, cough, and severe nausea. The patient had been admitted a month earlier with severe lower gastrointestinal bleeding from hemorrhoids necessitating transfusion of 7 units of packed red blood cells. Initial work-up was unremarkable. Because of persistent symptoms, the patient was admitted 2 days later. Malaria smear was positive. Due to the severity of her symptoms, she was managed as falciparum malaria and was started on intravenous quinine and oral doxycycline. On the second day of treatment the patient developed respiratory failure, requiring intubation and ventilatory support with new bilateral pulmonary infiltrates. Antimalarial treatment was continued for a total of 7 days followed by primaquine for 14 days once the blood smear results revealed Plasmodium ovale infection. The patient remained intubated in the intensive care unit (ICU) for 16 days, and was later extubated successfully with a clear chest x-ray after a total of one month hospitalization. To our knowledge, this is the first case of acute respiratory distress syndrome (ARDS) secondary to blood transfusion related P. ovale malaria infection in a non-endemic country.
Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon. souha-haydoura@hotmail.com
Souha
S
Haydoura
Ola
O
Mazboudi
Khalil
K
Charafeddine
Imad
I
Bouakl
Tania A
TA
Baban
Ali T
AT
Taher
Souha S
SS
Kanj
D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008288:Malaria / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D041122:Plasmodium ovale / Q000302:isolation & purification*; D017713:Platelet Transfusion / Q000009:adverse effects*; D011319:Primaquine / Q000627:therapeutic use; D011803:Quinine / Q000008:administration & dosage / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology*
D000962:Antimalarials; D011803:Quinine; D011319:Primaquine; D004318:Doxycycline