title: A case of vivax malaria complicated by adult respiratory distress syndrome and successful management with extracorporeal membrane oxygenation.
abstract: Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.
authors: Department of Internal Medicine, Inha University School of Medicine, Incheon 400-712, Korea.
authors: Hyun-Jung
authors: HJ
authors: Lee
authors: Ji-Hyeon
authors: JH
authors: Baek
authors: Myoung-Hun
authors: MH
authors: Chae
authors: Hoyeon
authors: H
authors: Joo
authors: Jin-Soo
authors: JS
authors: Lee
authors: Moon-Hyun
authors: MH
authors: Chung
authors: Yun-Kyu
authors: YK
authors: Park
authors: Joung-Teak
authors: JT
authors: Kim
mesh_terms: D058186:Acute Kidney Injury; D000962:Antimalarials / Q000008:administration & dosage*; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D000860:Hypoxia; D008168:Lung / Q000000981:diagnostic imaging; D016780:Malaria, Vivax / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D010966:Plasmodium vivax / Q000302:isolation & purification*; D011859:Radiography; D056910:Republic of Korea; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials
keywords: Plasmodium vivax; acute kidney injury; adult respiratory distress syndrome (ARDS); case report; extracorporeal membrane oxygenation (ECMO); shock; vivax malaria