The devastating global health issue of malaria persists. The cause of malaria is an infection of red blood cells with the plasmodium protozoa. Any one or more of the following four species can infect humans. Due to its potential for rapid progression, it can easily lead to severe complications and death in the absence of prompt and effective treatment. Therefore, malaria can be a medical emergency. Plasmodium falciparum almost exclusively causes severe malaria. This article discusses the severe form of malaria and its complications along with its management.
What precisely is severe malaria?
Almost all cases of severe malaria and malaria-related deaths are a result of P. falciparum. Its detection is easy by microscopy or a rapid diagnostic test or by the occurrence of any severe symptoms. A severe case of malaria can exhibit several symptoms, including impaired consciousness, respiratory distress, multiple convulsions, shock, pulmonary oedema, abnormal bleeding, yellowed skin and white portions of the eyes, severe anaemia, reduced blood sugar levels, acidosis, hyperlactatemia, renal impairment, or aggravated parasitic infection. Furthermore, mortality can rise above 50% when a number of prognostic factors are present. P. vivax and P. ovale rarely result in fatalities, crippling relapses, or other serious complications.
What complications can severe malaria cause?
Among the most serious complications of severe malaria are cerebral malaria, pulmonary oedema, acute renal failure, severe anaemia, and/or bleeding. The most frequent metabolic complications are acidosis and decreased blood sugar levels. Any of these complications can materialize quickly and result in death in a matter of hours or days. In many patients, several of these complications coexist or develop quickly over a short. Therefore, doctors should evaluate patients for any of these symptoms or signs that point to a higher risk of complications. The patients must start receiving treatment right away.
Patients with severe malaria should receive care in an ICU. Generally, clinical deterioration to severe malaria appears 3–7 days after the onset of a high fever, though there have been a few limited instances of nonimmune patients passing away within 24 hours of showing symptoms. It should emphasize that even after the initial treatment response and complete parasitic infection clearance, severe malaria may still manifest because of delayed cytokine release.
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