Volume 77, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Fatal complications of malaria have been reported. However, complicated malaria is rare. We observed two unusual cases of 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 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 malarial infection in patients with a clinical picture resembling toxic shock if they have a travel history to malaria-endemic areas.


Article metrics loading...

Loading full text...

Full text loading...



  1. Greenwood BM, Bojang K, Whitty CJ, Targett GA, 2005. Malaria. Lancet 365 : 1487–1498.
  2. Guerin PJ, Olliaro P, Nosten F, Druilhe P, Laxminarayan R, Binka F, Kilama WL, Ford N, White NJ, 2002. Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development. Lancet Infect Dis 2 : 564–573.
  3. Ree HI, 2000. Unstable vivax malaria in Korea. Korean J Parasitol 38 : 119–138.
  4. Yeom JS, Ryu SH, Oh S, Lee WJ, Kim TS, Kim KH, Kim YA, Ahn SY, Cha JE, Park JW, 2005. Status of Plasmodium vivax malaria in the republic of Korea during 2001–2003. Am J Trop Med Hyg 73 : 604–608.
  5. Islam N, Qamruddin K, 1995. Unusual complications in benign tertian malaria. Trop Geogr Med 47 : 141–143.
  6. Torres JR, Perez H, Postigo MM, Silva JR, 1997. Acute non-cardiogenic lung injury in benign tertian malaria. Lancet 350 : 31–32.
  7. Kim SM, Kim KB, Jung HJ, Kim WJ, Kim MJ, Park SC, 1997. Retinal hemorrhage in an adult with P. vivax malaria. Korean J Infect Dis 29 : 323–326.
  8. Cho D, Kim KH, Park SC, Kim YK, Lee KN, Lim CS, 2001. Evaluation of rapid immunocapture assays for diagnosis of Plasmodium vivax in Korea. Parasitol Res 87 : 445–448.
  9. Newbold C, Craig A, Kyes S, Rowe A, Fernandez-Reyes D, Fagan T, 1999. Cytoadherence, pathogenesis and the infected red cell surface in Plasmodium falciparum. Int J Parasitol 29 : 927–937.
  10. Simpson JA, Silamut K, Chotivanich K, Pukrittayakamee S, White NJ, 1999. Red cell selectivity in malaria: a study of multiple-infected erythrocytes. Trans R Soc Trop Med Hyg 93 : 165–168.
  11. Horuk R, Chitnis CE, Darbonne WC, Colby TJ, Rybicki A, Hadley TJ, Miller LH, 1993. A receptor for the malarial parasite Plasmodium vivax: the erythrocyte chemokine receptor. Science 261 : 1182–1184.
  12. Oh MD, Shin H, Shin D, Kim U, Lee S, Kim N, Choi MH, Chai JY, Choe K, 2001. Clinical features of vivax malaria. Am J Trop Med Hyg 65 : 143–146.
  13. Gandapur AS, Khattak S, Khan H, 1988. A patient with vivax malaria and enteric fever presenting as a case of jaundice with leukaemoid reaction. Pak Med Assoc 38 : 148–149.
  14. Nicholas J, 1996. Malaria. Gordon CC, ed. Manson’s Tropical Disease. 20th edition. London: W. B. Saunders, 1087–1163.

Data & Media loading...

  • Received : 18 Jan 2006
  • Accepted : 02 Mar 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error