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Am. J. Trop. Med. Hyg., 77(4), 2007, pp. 609-611
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Two Cases of Plasmodium vivax Malaria with the Clinical Picture Resembling Toxic Shock

Joon Young Song, Cheong Won Park, You Mee Jo, Jeong Yun Kim, Jeong Hyun Kim, Hyo Joong Yoon, Chi Hoon Kim, Chae Seung Lim, Hee Jin Cheong*, AND Woo Joo Kim
Division of Infectious Diseases, Department of Internal Medicine, and Department of Laboratory Medicine, Korea University, Seoul, Republic of Korea; Armed Forces Byeokje Hospital, Kyonggi Province, Republic of Korea

Fatal complications of Plasmodium falciparum malaria have been reported. However, complicated P. vivax malaria is rare. We observed two unusual cases of P. vivax malaria who presented with clinical pictures of toxic shock. Both showed disseminated intravascular coagulation with marked thrombocytopenia, oliguric renal failure, and pulmonary edema. Examination of initial blood smears showed a P. vivax parasitemia of 2,352/µL and 12,376/µL, respectively. The patients were treated with hydroxychloroquine and primaquine without an antibacterial agent. These cases emphasize the importance of considering the possibility of P. vivax malarial infection in patients with a clinical picture resembling toxic shock if they have a travel history to malaria-endemic areas.

Received January 18, 2006. Accepted for publication March 2, 2006.

* Address correspondence to Hee Jin Cheong, Section of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, 97 Guro Dong-Gil, Guro Gu, (152-703) Seoul, Republic of Korea. E-mail: heejinmd{at}medimail.co.kr

Authors’ addresses: Joon Young Song, Cheong Won Park, You Mee Jo, Jeong Yun Kim, Hee Jin Cheong, and Woo Joo Kim, Division of Infectious Diseases, Department of Internal Medicine, Korea University, Seoul, Republic of Korea. Jeong Hyun Kim, Hyo Joong Yoon, and Chi Hoon Kim, Armed Forces Byeokje Hsopital, Kyonggi Province, Republic of Korea. Chae Seung Lim, Department of Laboratory Medicine, Korea University, Seoul, Republic of Korea.

Reprint requests: Hee Jin Cheong, Section of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, 97 Guro Dong-Gil, Guro Gu, (152-703) Seoul, Republic of Korea, Telephone: 82-2-818-6649, Fax: 82-2-866-1643, E-mail: heejinmd{at}medimail.co.kr.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.