Pulmonary Complications in Falciparum Malaria

Malaria is a treatable cause of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Due to variation in clinical presentation, pulmonary manifestations in malaria have always been under diagnosed. A total 95 patients with severe falciparum malaria were included in this study. The diagnosis of malaria was confirmed by examination of peripheral smear / OptiMal test/ QBC. Arterial blood gas analysis was done in patients who developed respiratory symptom. It was observed that out of 41 patients showing respiratory symptoms ARDS was present 8 ( (8.42 %) no. of cases, Acute lung injury in 4 (4.21 %) cases and Pneumonia in 4 (4.21 %) cases. ARDS was more common in patients with heavy parasitemia (75 % with greater than20 % parasitemia), hypoalbuminemia (75 %) and anemia (62.5 %). All patients with respiratory distress were given ventilator support. Patients with ARDS showed a high mortality rate of 75 %. ARDS in malaria have a poor disease outcome. Early diagnosis, institution specific antimalarial treatment and assisted ventilation can be life-saving.