Severe Malaria in the Intensive Care Unit: The report of a Case of a Non-Endemic Species in North of Santander, Colombia
Keywords:
Malaria, Malaria, Falciparum, Respiratory Distress Syndrome, Adult, Renal Insufficiency, Intensive Care Units, Critical Care
Abstract
Introduction: Malaria is a vector-borne infectious disease which is predominant in tropical and subtropical regions. There are 5 serotypes of Plasmodium, in Colombia there are two serotypes for endemic malaria, P. vivax and P. falciparum. North of Santander is an endemic area for P. vivax. Objective: To show a case of severe malaria caused by P. falciparum, with a brief description of the pathophysiological aspects of severe malaria and the advent of new antimalarial therapies. Case Presentation: A 45-year-old male patient from an endemic region with P. falciparum, who was admitted due to nonspecific febrile symptoms, severe thrombocytopenia, impaired renal and hepatic functions with deterioration of his general condition. He is transferred to the intensive care unit as a dialytic urgency. Severe malaria due to P. falciparum was diagnosed, he is treated with antimalarial medication, and a possible coinfection is reported for the dengue virus due to a positive immunoglobulin M (IgM) result, so he receives a renal replacement therapy. The case is contextualized in a vicious circle of organ dysfunction, which is structured between renal failure and acute respiratory failure with an increased vascular permeability and refractory hypoxemia; despite the therapeutic effort, the patient dies due to multiple organ failures, and severe malaria. Conclusions: Malaria is a problem in the public health area. This case corresponds to imported malaria because this serotype has not been identified yet in the department of North of Santander. [Ortiz-Ruiz G, Urbina-Contreras ZE, Lamos-Duarte AF, Ferreira MF, García-Zambrano F. Severe Malaria in the Intensive Care Unit: The report of a Case of a Non-Endemic Species in North of Santander, Colombia. MedUNAB 2017-2018; 20(3): 383-392].
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28. World Healt Organization. Deungue: guidelines for diagnostic, treatment, prevention and control. [Internet]. 2009. [cited 4 July 2017]. Disponible en: http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf
29. Cheng M, Yansouni C. Management of Severe Malaria in the Intensive Care Unit. Critical Care Clinics [Internet]. 2013 [cited 4 July 2017]. 29(4):865-885. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24094382
30. Bruneel F. Severe Imported Falciparum Malaria: A Cohort Study in 400 Critically Ill Adults. PLoS ONE [Internet]. 2010 [cited 4 July 2017]. 5(10):e13236. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951913/pdf/pone.0013236.pdf
2. Nadjm B, Behrens R. Malaria: An Update for Physicians. Infectious Disease Clinics. 2012; 26(2): 243-259.
3. Fazil A, Vernekar P, Geriana D, Pant S, Senthilkumaran S, et al. Clinical profile and complication of malaria hepatopathy. Journal of Infection and Public Health. 2013; 6(5): 383-388.
4. Miranda A, Martínez E, Tobón A. El riñón en la malaria: de la patogénesis a las manifestaciones clínicas. Infectio. 2014; 18(3): 120-128.
5. World Health Organization. World malaria report 2012. [Internet] Geneva, 2012. [Cited: 4 July 2017]. Disponible en: http://www.who.int/malaria/publications/world_malaria_report_2012/en/
6. Instituto Nacional de Salud. Guía de Atención Clínica de Malaria. [Internet]. 2010. [Cited: 4 July 2017]. Disponible en: http://www.ins.gov.co/?idcategoria=5620
7. Ehrich J, Eke F. Malaria-induced renal damage: facts and myths. Pediatr Nephrol. 2007; 22(5): 626-637.
8. Blair S, Giraldo C. Complicaciones renales en la malaria. Acta Méd colombi. 2004; 29: 328-36.
9. Nguansangiam S, Day N, Hien T, Hoang N, Chaisri U et al. A quantitative ultrastructural study of renal pathology in fatal Plasmodium falciparum malaria. Tropical Medicine & International Health. 2007; 12(9): 1037-1050.
10. Chellappan A, Bhadauria D. Acute kidney injury in malaria: An update. Clinical Queries: Nephrology. 2016; 5(1): 26-32.
11. Bhadade R, Harde M, de Souza R, Khot A. Clinical characteristics and outcomes of patients with acute lung injury and ARDS. Journal of Postgraduate Medicine. 2011; 57(4): 286-290.
12. Van den Steen P, Deroost K, Deckers J, Van Herck E, Struyf S, Opdenakker G. Pathogenesis of malaria-associated acute respiratory distress syndrome. Trends in Parasitology. 2013; 29(7): 346-358.
13. Matthay M, Zemans R. The Acute Respiratory Distress Syndrome: Pathogenesis and Treatment. Annu Rev Pathol. 2011; 6(1): 147-163.
14. Tan L, Yacoub S, Scott S, Bhagani S, Jacobs M. Acute lung injury and other serious complications of Plasmodium vivax malaria. The Lancet Infectious Diseases. 2008; 8(7): 449-454.
15. Cheng M, Yansouni C. Management of Severe Malaria in the Intensive Care Unit. Critical Care Clinics. 2013; 29(4): 865-885.
16. Hanson J, Hasan M, Royakkers A, Alam S, Charunwatthana P, Maude R, et al. Laboratory prediction of the requirement for renal replacement in acute falciparum malaria. Malar J. 2011; 10:217. Disponible en: https://doi.org/10.1186/1475-2875-10-217
17. Marks M, Armstrong M, Suvari M, Batson S, Whitty C, Chiodini P, et al. Severe imported falciparum malaria among adults requiring intensive care: a retrospective study at the hospital for tropical diseases, London. BMC Infect Dis. 2013; 13(118): 1-8. Disponible en: https://doi.org/10.1186/1471-2334-13-118
18. Villa G, Ricci Z, Ronco C. Renal Replacement Therapy. Critical Care Clinics. 2015; 31(4): 839-848.
19. Instituto departamental de salud Norte de Santander. Análisis de situación de salud (ASIS) en municipios de frontera. [Internet]. 2010. [cited 4 July 2017]. pág. 96. Disponible en: https://www.minsalud.gov.co/plandecenal/mapa/Analisis-de-Situacion-de-Salud-en-municipios-de-frontera-Departamento-Norte-Santander.pdf
20. Proyecto Fondo Mundial Malaria. Uso de la inteligencia epidemiológica con participación social, para fortalecer la gestión del programa, mejorar el acceso al diagnóstico y tratamiento y ejecutar intervenciones eficaces para la prevención y control de la malaria, Colombia 2010-2015. [Internet]. [Cited 4 july 2017]. Disponible en: http://simposiovirologia.ins.gov.co/temas-de-interes/Documentacin%20Malaria/Proyecto%20Malaria%20Colombia.pdf
21. Sagaki P, Thanachartwet V, Desakorn V, Sahassananda D, Chamnanchanunt S, et al. Clinical Factors for Severity of Plasmodium falciparum Malaria in Hospitalized Adults in Thailand. PLoS ONE [Internet]. 2013 [cited 4 July 2017]. 8(8):e71503. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741184/pdf/pone.0071503.pdf
22. Kute V, Shah P, Munjappa B, Gumber M, Patel H, Jain S, et al. Outcome and prognostic factors of malaria-associated acute kidney injury requiring hemodialysis: A single center experience. Indian J Nephrol. 2012; 22(1): 33-38.
23. Marks M, Gupta-Wright A, Doherty J, Singer M, Walker D. Managing malaria in the intensive care unit. British Journal of Anaesthesia [Internet]. 2014 [cited 4 July 2017]. 113(6):910-921. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235570/pdf/aeu157.pdf
24. Saravu K, Rishikesh K, Kamath A. Determinants of mortality, intensive care requirement and prolonged hospitalization in malaria – a tertiary care hospital based cohort study from South-Western India. Malaria Journal [Internet]. 2014 [cited 4 July 2017]. 13(1):370. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177244/
25. Sahu S, Mohanty N, Rath J, Patnaik S. Spectrum of malaria complications in an intensive care unit. Singapore Medicine jorunal [Internet]. 2010 [cited 4 July 2017]. 51(3): 226-229. Disponible en: http://smj.sma.org.sg/5103/5103a5.pdf
26. Bruneel F, Tubach F, Mira J, Houze S, Gibot S, et al. Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study. Intensive Care Medicine [Internet]. 2016 [cited 4 July 2017]. 42(10):1588-1596. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27169586.
27. Doctor S, Liu Y, Whitesell A, Thwai K, Taylor S, Janko M, et al. Malaria surveillance in the Democratic Republic of the Congo: comparison of microscopy, PCR, and rapid diagnostic test. Diagn Microbiol Infect Dis. 2016; 85(1): 16-18. Disponible en: http://dx.doi.org/10.1016/j.diagmicrobio.2016.01.004.
28. World Healt Organization. Deungue: guidelines for diagnostic, treatment, prevention and control. [Internet]. 2009. [cited 4 July 2017]. Disponible en: http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf
29. Cheng M, Yansouni C. Management of Severe Malaria in the Intensive Care Unit. Critical Care Clinics [Internet]. 2013 [cited 4 July 2017]. 29(4):865-885. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24094382
30. Bruneel F. Severe Imported Falciparum Malaria: A Cohort Study in 400 Critically Ill Adults. PLoS ONE [Internet]. 2010 [cited 4 July 2017]. 5(10):e13236. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951913/pdf/pone.0013236.pdf
How to Cite
1.
Ortíz-Ruíz G, Urbina-Contreras ZE, Lamos-Duarte AF, Ferreira MF, García-Zambrano F. Severe Malaria in the Intensive Care Unit: The report of a Case of a Non-Endemic Species in North of Santander, Colombia. MedUNAB [Internet]. 2018 Jul. 5 [cited 2026 Mar. 9];20(3):383-92. Available from: https://revistasunabeduco.biteca.online/index.php/medunab/article/view/2669
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Published
2018-07-05
Section
Case Report
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