Abstract

Occasionally, malaria may present with unusual signs and symptoms. We report a case of an uncommon presentation of Plasmodium falciparum infection in a 59-year-old Ethiopian immigrant, which initially presented with hyperglycaemia and multiple organ dysfunction syndrome (MODS). Reports of unusual presentations of malaria are few and cases of severe malaria with hyperglycaemia are rarely described. As hyperglycaemia is associated to most severe malaria and high mortality, our aim is to catch the attention of the physicians on this entity.

Highlights

  • IntroductionWe describe a case of severe P. falciparum imported malaria with hyperglycaemia and multiple organ dysfunction syndrome (MODS)

  • Severe imported malaria remains a major threat to travelers

  • We report a case of an uncommon presentation of Plasmodium falciparum infection in a 59-year-old Ethiopian immigrant, which initially presented with hyperglycaemia and multiple organ dysfunction syndrome (MODS)

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Summary

Introduction

We describe a case of severe P. falciparum imported malaria with hyperglycaemia and MODS. Rare, this syndrome should be considered in patients brought to the emergency department after travelling to an area where malaria is endemic. The patient had stayed both in rural and urban areas. She had not taken any malaria chemoprophylaxis during the trip. The patient was admitted to intensive care unit (ICU) and she was treated for 7 days with intravenous quinine 10 mg/kg every 8 hours after an initial loading dose of 20 mg/kg, for 7 days with doxycycline 100 mg.iv. During the acute phase the patient was described with angina pectoris with normal troponin T levels; ECG showed T-wave alterations and echocardiography a global left ventricular hypokinesia; a supportive care with dopamine and nitrates was necessary

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