Clinical observation of a patient with severe malaria clinical course in outpatient conditions


DOI: https://dx.doi.org/10.18565/therapy.2024.7.129-138

Karpenko D.G., Lukyanova E.A., Ponomareva A.V., Larina V.N.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Abstract. Article presents a clinical case of mixed malaria infection caused by Plasmodium falciparum and Plasmodium ovale. Due to the pathogenic properties of the causative agent of tropical malaria and the delay in the starting of medicamentous treatment, the patient developed complications such as cerebral edema (cerebral form of tropical malaria) and multiple organ failure in 7 days after the onset of clinical signs. After 3 weeks of his recovery and discharge from the hospital, he was hospitalized with fever syndrome in the infectious diseases hospital. During the second hospitalization, he was diagnosed with ovale malaria. Current clinical case illustrates the possibility of developing a mixed infection with different incubation periods of pathogens. It is necessary to remember the resistance to antimalarial therapy of the second pathogen, which was in the incubation period at the time of treatment. Clinical observation also demonstrates the objective difficulties of timely diagnosis of malaria at the outpatient stage. Late initiation of treatment led to the development of severe life-threatening complications, which confirms the need for a thorough diagnostic search in patients with fever, careful study of the epidemiological history.
Keywords: fever of unknown genesis, ovale malaria, tropical malaria, mixed infection, multiple organ failure, fever
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About the Autors

Dmitry G. Karpenko, MD, PhD (Medicine), associate professor of the Department of outpatient therapy of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: karpenko_dg@mail.ru
ORCID: https://orcid.org/0000-0002-1924-9514
Ekaterina A. Lukyanova, student of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: yekaterina.lukyanova.99@bk.ru
ORCID: https://orcid.org/0009-0007-1229-3671
Anastasia V. Ponomareva, student of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: ana.ponom22@mail.ru
ORCID: https://orcid.org/0009-0008-4049-9885
Vera N. Larina, MD, Dr. Sci. (Medicine), professor, head of the Department of outpatient therapy of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: larinav@mail.ru
ORCID: https://orcid.org/0000-0001-7825-5597


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