SHM Converge Scientific Abstract ePoster Gallery-Progression of Severe Malaria in a Young Male Patient From Senegal

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This case report describes rapidly progressive severe malaria in a 25-year-old man recently arrived from Senegal, an area where malaria is endemic. He presented with 3 days of intermittent fever, headache, abdominal pain, vomiting, diarrhea, and dark urine. On arrival, he was diaphoretic, dehydrated, febrile, tachycardic, hypoglycemic, and jaundiced, with mosquito bites noted on examination.<br /><br />Laboratory findings showed severe anemia, severe thrombocytopenia, lactic acidosis, indirect hyperbilirubinemia, and acute kidney injury. A blood smear was positive for malaria, and PCR confirmed Plasmodium falciparum with 40% parasitemia, indicating severe disease with hyperparasitemia and multi-organ involvement.<br /><br />During hospitalization, the patient developed lethargy, hypoxia, and worsening anemia, requiring transfer to the ICU. He was treated with three doses of intravenous artesunate, after which his condition improved rapidly. He was then transitioned to oral artemether-lumefantrine. Repeat blood smears showed complete parasite clearance, and he was discharged home.<br /><br />The report emphasizes that in the United States, malaria is usually travel-related, and severe cases in New York City are strongly associated with recent arrival from West Africa. It highlights the importance of considering malaria in any patient with compatible symptoms and relevant travel or immigration history.<br /><br />The authors stress that severe malaria can deteriorate quickly and requires close monitoring, frequent laboratory assessment, early ICU admission when indicated, and serial smears every 12–24 hours until parasites are cleared. Prompt treatment with IV artesunate can lead to rapid improvement, and completion of oral artemisinin-based combination therapy is essential to prevent relapse.

Asset Subtitle

Fahema Nadira

Meta Tag

Author List Aesha Patel, Fahema Nadira, Krystina WOODS

Category Clinical Vignettes

Concept Malaria

Concept Plasmodium falciparum

Concept Severe Malaria

Concept Intravenous artesunate

Concept Hyperparasitemia

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside/West Internal Medicine Program

Presenting Author Fahema Nadira

Track Adult

Keywords

severe malaria

Plasmodium falciparum

hyperparasitemia

intravenous artesunate

West Africa

Senegal

acute kidney injury

thrombocytopenia

ICU admission

artemether-lumefantrine

Malaria

Plasmodium falciparum

Severe Malaria

Intravenous artesunate

Hyperparasitemia