Hülya GÜNBATAR, Bünyamin SERTOĞULLARINDAN, Selami EKİN, Aysel SÜNNETCİOĞLU, Bülent ÖZBAY

A case of Plasmodium vivax malaria with respiratory failure

Akut böbrek yetmezliği, dissemine intravasküler koagülasyon, akut solunum sıkıntısı sendromu (ARDS), hipoglisemi, koma veya epileptik nöbet ağır Plasmodium falciparum’un bulgularıdır. Plasmodium vivax nadiren ciddi komplikasyonlara neden olur. Hastane bahçesinde bilinçsiz olarak bulunan 30 yaşında erkek Pakistanlı mülteci bir olguyu sunuyoruz. Yoğun bakım desteği gerektiren pnömoni tedavisi ve yoğun bakım desteğinden sonra invaziv mekanik ventilasyondan ayrıldı. Devam eden ateş ve titreme atakları nedeniyle sıtma tanısı üzerine odaklanıldı, Plasmodium vivax kalın periferik yaymada tespit edildi. Yoğun bakım desteği ve spesifik antiplasmodial tedavisonrası hasta iyileşti ve hastaneden taburcu edildi. ARDS ilişkili Plasmodium vivax’da mekanik ventilasyon kullanı-mı olumlu sonuçla ilişkiliydi.

Solunum yetmezliğinin eşlik ettiği Plasmodium vivax malaria olgusu

Acute renal failure disseminated intravascular coagulation, acute respiratory distress syndrome (ARDS), hypoglycemia, coma or epileptic seizures are manifestationsof severe Plasmodium (P.) falciparum malaria. P. vivaxmalaria is rarely associated with severe complications.We report a case of 30-year-old male refugee comingfrom Pakistan, has been found in hospital garden as un-conscious. After therapy of pneumonia requiring intensivecare unit and intensive supportive care, the patient leftinvasive mechanical ventilation (IMV). Because of contin-ued fever and chills attacks focused on malaria diagnosis,Plasmodium vivax malaria detected on thick peripheralblood smear. After intensive supportive care and specificanti-plasmodial therapy, the patient recovered and wasdischarged from hospital. The use of IMV vivax-malariarelated ARDS was associated with a good outcome.

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1. Greenwood BM, Fidock DA, Kyle DE, et al. Malaria: progress, perils, and prospects for eradication. J Clin Invest 2008;118:1266-1276.
2. Kumar S, Melzer M, Dodds P, et al. Vivax malaria complicated by shock and ARDS. Scand J Infect Dis. 2007;39:255-256.
3. Price L, Planche T, Rayner C, Krishna S. Acute respiratory distress syndrome in Plasmodium vivax malaria: Case report and review of the literature. Trans R Soc Trop Med Hyg 2007;101:655-659.
4. Kasliwal P, Rao MS, Kujur R. Plasmodium vivax malaria: An unusual presentation. Indian J Crit Care Med 2009;13:103-105.
5. Nayak KC, Mohini S, Kumar RS, et al. A study on pulmonary manifestations in patients with malaria from Northwestern India (Bikaner). J Vector Borne Dis 2011;48:219-223.
6. Mishra U, Ray G. Pulmonary manifestation of malaria. Chest 2005;128:376.
7. Anstey NM, Jacups SP, Cain T, et al. Pulmonary manifestations of uncomplicated falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis 2002;185:1326-1334.
8. McGready R, Davison BB, Stepniewska K, et al. The ef- fects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission. Am J Trop Med Hyg 2004;70:398-407.
9. Sarkar S, Saha K, Das CS. Three cases of ARDS: An emerging complication of Plasmodium vivax malaria. Lung India 2010;27:154-157.
10. Agarwal R, Nath A, Gupta D. Noninvasive ventilation in Plasmodium vivax related ALI/ARDS. Intern Med. 2007;46:2007-2011.