Severe Plasmodium falciparum Malaria with Acute Chest Syndrome in a Sickle Cell Anemia Patient

It is now generally accepted that sickle cell trait is protective against malaria. People with sickle cell anemia (SCA) also have been shown to have a lower incidence of malaria compared to the general population, though the combination of SCA and malaria significantly increases risk of severe malaria, thereby posing a higher risk for mortality [1]. Malaria worsens the anemia associated with SCA, potentially causing life-threatening complications [2,3]. Additionally, the invasion of red blood cells (RBCs) by malaria parasites triggers extensive sickling and increases the adhesion of infected sickle cells to blood vessel walls, promoting vaso-occlusive crises (VOCs) [4]. Severe VOC can subsequently lead to acute chest syndrome (ACS), characterized by fever, respiratory distress, and new lung infiltrates on chest X-rays. We report a case of severe Plasmodium falciparum infection in a patient with SCA complicated by possible ACS, which was successfully treated with intravenous (IV) artesunate and RBC exchange transfusion.