Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Two Cases of Falciparum Malaria with Acute Respiratory Distress Syndrome

중증 열대열 말라리아에 동반된 급성호흡곤란증후군 2예

  • Park, Joo-Hun (Department of Internal medicine, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Shin, Eun-Sug (Department of Internal medicine, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Woo, Jun-Hee (Department of Internal medicine, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Kim, Yeun-Ok (Department of Internal medicine, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Bae, In-Gyu (Department of Internal medicine, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Jang, Jae-Jeong (Department of Diagnostic pathology, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Chi, Hyun-Sook (Department of Clinical pathology, Asan Medical Center, University of Ulsan, College of Medicine) ;
  • Koh, Youn-Suck (Department of Internal medicine, Asan Medical Center, University of Ulsan, College of Medicine)
  • 박주헌 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 신은석 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 우준희 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 김은옥 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 배인규 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 장재정 (울산대학교 의과대학 서울중앙병원 진단병리학교실) ;
  • 지현숙 (울산대학교 의과대학 서울중앙병원 임상병리학 교실) ;
  • 고윤석 (울산대학교 의과대학 서울중앙병원 내과학교실)
  • Published : 1998.08.30
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Abstract

Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features that make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria, hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.

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