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 Release 22.0, Sept. 2008
 
Chapter : ch24. Parasitology & Medical Entomology Section : Malaria
  Respiratory Complaints in a Patient with Vivax Malaria

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Copyright (c) 2008-2010, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

A patient with Plasmodium vivax malaria may develop respiratory complaints in addition to fever.

 

Mechanisms:

(1) sequestration of parasitized erythrocytes within the lung vasculature by adhering to endothelial cells

(2) alveolar-capillary inflammation following treatment

 

Clinical manifestations:

(1) cough

(2) tachypnea (with respiratory rate > 24 breaths per minute)

(3) chest crackles (rales)

(4) normal spirometric studies (FEV1, FVC)

(5) a decrease in diffusion capacity of carbon monoxide (DLco)

(6) decrease in oxygen saturation with treatment

 

Severe cases may develop acute respiratory distress syndrome (ARDS) with noncardiogenic pulmonary edema.

 

Differential diagnosis:

(1) acute upper respiratory infection

(2) pneumonia

 

  References:

Anstey NM, Jacups SP, et al. Pulmonary manifestations of uncomplication falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infectious Diseases (JID). 2002; 185: 1326-1334.

Anstey NM, Handojo T, et al. Lung injury in vivax malaria: Pathophysiological evidence for pulmonary vascular sequestration and posttreatment alveolar-capillary inflammation. J Infectious Diseases (JID). 2007; 195: 589-596.

 

 

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