Severe malaria vivax with sepsis bacterial: a case report

1st International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) Faculty of Medicine Universitas Sumatera Utara

Tarigan, P.^1,2 ; Ginting, F.^1,2

Division of Infectious and Tropical Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan

20136, Indonesia^1

Haji Adam Malik Central General Hospital, Jl Bungalau No 17, Medan

20136, Indonesia^2

关键词: Antibiotic treatment;    Clinical manifestation;    Diagnostic tests;    Early diagnosis;    Hepatic impairment;    Intravenous fluids;    Plasmodium falciparum;    Procalcitonin;   

Others  :  https://iopscience.iop.org/article/10.1088/1755-1315/125/1/012078/pdf
DOI  :  10.1088/1755-1315/125/1/012078

来源: IOP

【 摘 要 】

Malaria cases are often misdiagnosis by clinicians in tropical areas like Indonesia. Some cases show overlapping signs and symptoms of another infection that are common in the tropical areas such as typhoid, dengue, and leptospirosis. It can be misdiagnosed in practice and led to a wrong management that can end fatally. Severe malaria is usually caused by Plasmodium falciparum. P. vivax can also cause severe malaria but the cases reported are uncommon. Since infections with severe P. vivax that generally results in serious disease is quite uncommon in Indonesia, their identification and management are important. We report a case of severe malaria with sepsis, renal injury and hepatic impairment associated with malaria in a 70-year-old male. Clinical manifestations included anemia, sepsis, and elevated serum creatinine, urea, total bilirubin, and procalcitonin. The rapid diagnostic test for malaria and microscopic examination of blood smears were positive for P. vivax. The patient was treated as severe malaria with intravenous artesunate for six days, followed by oral treatment of primaquine for 14 days. Intravenous fluid therapy, antipyretic, anti-malaria and antibiotic treatment were administered. The patient was stable and then discharged from the hospital. The prognosis depends much on early diagnosis and appropriate supportive treatment.