title: Delayed Diagnosis of Falciparum Malaria with Acute Kidney Injury.
abstract: Prompt malaria diagnosis is crucial so antimalarial drugs and supportive care can then be rapidly initiated. A 15-year-old boy who had traveled to Africa (South Africa, Kenya, and Nigeria between January 3 and 25, 2011) presented with fever persisting over 5 days, headache, diarrhea, and dysuria, approximately 17 days after his return from the journey. Urinalysis showed pyuria and hematuria. Blood examination showed hemolytic anemia, thrombocytopenia, disseminated intravascular coagulation, and hyperbilirubinemia. Plasmapheresis and hemodialysis were performed for 19 hospital days. Falciparum malaria was then confirmed by peripheral blood smear, and antimalarial medications were initiated. The patient's condition and laboratory results were quickly normalized. We report a case of severe acute renal failure associated with delayed diagnosis of falciparum malaria, and primary use of supportive treatment rather than antimalarial medicine. The present case suggests that early diagnosis and treatment is important because untreated tropical malaria can be associated with severe acute renal failure and fatality. Physicians must be alert for correct diagnosis and proper management of imported tropical malaria when patients have travel history of endemic areas.
authors: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
authors: Iee Ho
authors: http://orcid.org/0000-0003-0935-7463
authors: IH
authors: Choi
authors: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
authors: Pyoung Han
authors: http://orcid.org/0000-0003-0108-0922
authors: PH
authors: Hwang
authors: Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors: Sam Im
authors: http://orcid.org/0000-0002-9201-9643
authors: SI
authors: Choi
authors: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
authors: Dae Yeol
authors: http://orcid.org/0000-0002-5733-2669
authors: DY
authors: Lee
authors: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea. children@jbnu.ac.kr.
authors: Min Sun
authors: http://orcid.org/0000-0002-3617-7823
authors: MS
authors: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications*; D000293:Adolescent; D016054:DNA, Protozoan / Q000032:analysis; D057210:Delayed Diagnosis; D005919:Glomerular Filtration Rate; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D008297:Male; D010963:Plasmodium falciparum / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D006435:Renal Dialysis
chemical_list: D016054:DNA, Protozoan
keywords: Diagnosis; Dialysis, Plasmapheresis; Malaria; Plasmodium falciparum; Renal Failure