SHM Converge Scientific Abstract ePoster Gallery-Malaria Myocarditis Due to Plasmodium Falciparum

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This report describes a rare case of severe <strong>Plasmodium falciparum malaria complicated by myocarditis</strong> in a previously healthy 43-year-old man who had recently traveled to East Africa without taking malaria chemoprophylaxis. He presented to the emergency department with very high fever, myalgia, hypotension, and tachycardia. Initial testing showed leukopenia, thrombocytopenia, acute kidney injury, elevated bilirubin, and metabolic acidosis. Blood smear confirmed <strong>P. falciparum parasitemia</strong> at 9.4%, later peaking at 39.4%. He was treated with <strong>intravenous artesunate</strong> for severe malaria.

On the second hospital day, he developed chest discomfort relieved by leaning forward. Cardiac evaluation showed a markedly elevated troponin I level, diffuse ST elevations on EKG, and reduced left ventricular function on echocardiogram with an ejection fraction of 40% and global hypokinesia. Because he was too unstable for cardiac MRI, ischemic workup, or biopsy, clinicians diagnosed <strong>malaria-associated myocarditis</strong> based on the clinical picture.

His illness progressed to <strong>multiorgan failure</strong>, including ARDS, renal failure, and liver failure, and he required a prolonged hospitalization of more than five weeks. Despite the severity of his condition, he gradually improved with artesunate and supportive care and was eventually discharged in stable condition.

The case emphasizes that although malaria is commonly associated with cerebral, respiratory, renal, and hepatic complications, <strong>cardiac involvement can also occur and may be underrecognized</strong>. The authors stress the importance of <strong>pre-travel counseling, malaria prophylaxis, and mosquito avoidance measures</strong> such as insect repellent and bed nets for non-immune travelers.

Asset Subtitle

Ei Thwe

Meta Tag

Author List Bruce Ferraro, Ei Thwe, Mahesh Krishnamurthy, William McIntosh

Category Clinical Vignettes

Concept Malaria

Concept Plasmodium falciparum

Concept Severe Malaria

Concept Artesunate

Concept Multiorgan Complications

Distinguished Non-Finalist

Presenter Organization St. Luke's University Health Network

Presenting Author Ei Thwe

Track Adult

Keywords

Plasmodium falciparum

severe malaria

myocarditis

intravenous artesunate

parasitemia

multiorgan failure

acute kidney injury

troponin I

travel medicine

malaria prophylaxis

Malaria

Plasmodium falciparum

Severe Malaria

Artesunate

Multiorgan Complications