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Tuberc Respir Dis > Volume 45(4); 1998 > Article
Tuberculosis and Respiratory Diseases 1998;45(4):888-895.
DOI: https://doi.org/10.4046/trd.1998.45.4.888    Published online January 1, 2001.
Two Cases of Falciparum Malaria with Acute Respiratory Distress Syndrome.
Joo Hun Park, , Eun Sug Shin, , Jun Hee Woo, , Yeun Ok Kim, , In Gyu Bae, , Jae Jeong Jang, , Hyun Sook Chi, , Youn Suck Koh,
1Department of Internal medicine, Asan Medical Center, University of Ulsan, Collge of Medicine, Seoul, Korea.
2Department of Diagnostic pathology, Asan Medical Center, University of Ulsan, Collge of Medicine, Seoul, Korea.
3Department of Clinical pathology, Asan Medical Center, University of Ulsan, Collge of Medicine, Seoul, Korea.
Abstract
Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features thai make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.
Key Words: Falciparum malaria, Lung injury, ARDS, Multi-organ failure


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