Modern clinical and laboratory indicators of severe Plasmodium falciparum malaria

According to WHO Report 2024, malaria is still a global health challenge, especially in Africa, Asia and South America. In the opinion of the authors, errors made in adequate assessment of clinical and laboratory indicators of P. falciparum malaria (tropical malaria) in a patient are the major reasons that can lead to a lethal disease outcome. The aim of our research was to describe the clinical and laboratory indicators of severe tropical malaria with a severe and complicated course of disease in a female patient, taking into account the analysis of data from modern scientific and medical literature, and our own experience. An abstract of the case history of patient M., 56 years old, is presented. The patient underwent medical treatment in an infectious disease hospital under the primary diagnosis of Plasmodium falciparum malaria with cerebral complications and acute renal failure, severe course of illness. She fell ill on Day 7 after her journey to Tanzania (Zanzibar Island). The disease developed in a severe, complicated form with acute renal failure, sepsis, severe anemia, bilateral polysegmental pneumonia, and nosebleeds. The parasitemia level reached 1,428,000 per microliter of blood. The treatment regimen of malaria included Coartem. Due to ongoing intensive therapy, positive changes were achieved. A stable absence of parasitemia was observed, however a peripheral edema and a high level of azotemia persisted. The patient continued to undergo treatment in the Department of Nephrology, where a significant clinical outcome in the form of decreased azotemia levels was achieved. The woman was discharged home in a satisfactory condition. The clinical case example fully reflects modern clinical and laboratory criteria for severe, complicated tropical malaria, and demonstrates rapid development of serious complications as a result of late admission to hospital. It represents a practical interest not only for infectious disease experts, but also for therapists, nephrologists, neurologists, resuscitationists and physicians of other specialties.