Pediatric emergency medicine trisk 2381 2381

Species

Predominant
region

P. falciparum Africa
Indian
subcontinent
Papua New
Guinea
Southeast Asia
Southern Central
America
Northern South
America
Haiti

P. malariae

Sub-Saharan
Africa
Southeast Asia

Complications
Hypoglycemia: the most common
complication of severe malaria;
symptoms of hypoglycemia can be
difficult to differentiate from malaria
symptoms (altered mentation,
diaphoresis, tachycardia)
Cerebral malaria: altered mentation,

seizures, encephalopathy, retinal
hemorrhages; focal neurologic signs are
rare; CSF demonstrates mild pleocytosis,
slightly elevated CSF protein, and very
low CSF glucose
Respiratory distress can be caused by
noncardiogenic pulmonary edema/ARDS
(due to malaria itself or fluid overload
after resuscitation) or to compensatory
respiratory alkalosis to compensate for
metabolic acidosis
Renal failure (acute tubular necrosis,
interstitial nephritis, glomerulonephritis;
“blackwater fever” with urinary
discoloration from hemoglobinuria)
Shock: hypovolemic and/or due to severe
anemia
Hepatic dysfunction: icterus with or without
hepatorenal syndrome; coagulopathy,
transaminitis, cholestasis, and both
conjugated and unconjugated
hyperbilirubinemia may be seen
Congenital malaria: risk is increased in
mothers with HIV infection
Anemia
Chronic asymptomatic parasitemia
Nephrotic syndrome