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KMID : 0984720050370020111
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Infection and Chemotherapy
2005 Volume.37 No. 2 p.111 ~ p.115
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A Case of Fatal Plasmodium Vivax Malaria with Multi-organ Failure
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Park Sang-Weon
Kim Dong-Woo
Park Ju-Won
Lee Soon-Il
Shin Young-Hack
Kim Eui-Chong
Oh Myoung-Don
Choe Kang-Won
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Abstract
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Vivax malaria is a re-emerging infectious disease in Korea with cumulating 19,416 cases as of December 2003 since 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there are only small number of case reports on severe complications. We experienced a fatal vivax malaria in a previously healthy young adult with severe multi-organ failure and fatal massive pulmonary hemorrhage. The patient presented with abdominal pain and shock. There were splenic hemorrhage, disseminated intravascular coagulation, oliguric acute renal failure requiring dialysis, and pulmonary hemorrhage leading the patient finally to death. The initial parasitemia was 2,046/μL. Thin smear and PCR revealed only Plasmodium Vivax. There was no explainable cause of death except for the only serological suggestion of Mycoplasma pneumoniae infection without correlating clinical evidence. This is a first case of fatal vivax malaria in Korea since its re-emergence in 1993. Further case monitoring is needed to define whether this is a index case or an isolated one.
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KEYWORD
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Plasmodium Vivax, Mycoplasma, Pulmonary hemorrhage, Multi-organ failure, Korea
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