ABSTRACT
Background and aims: In view of high incidence, increasing morbidity and mortality due to malaria in an endemic area like Bikaner, it was planned to study the clinical profile of multiorgan involvement in Plasmodium vivax, Plasmodium falciparum and mixed type of malaria. Material and methods: Prospective data were collected from 201 adult patients with multiorgan involvement, admitted in classified malaria ward and confirmed by asexual parasitemia in peripheral blood film. Results: Prevalence of renal failure was 57.7%, cerebral malaria 47.8%, jaundice 41.8%, severe anemia (hemoglobin [Hb] ≤5 g/dl) in 31.8%, severe thrombocytopenia, shock, septicemia in 19.9%, 12.4%, 8.96%, respectively. Out of this P. vivax was associated with renal failure in 10.4%, with cerebral malaria in 7.46%, with jaundice in 9.5% and with severe anemia in 3.5%. Multiorgan dysfunction was a major cause of death in 25.87% patients (18.4%, P. falciparum 6%, P. vivax 1.5%, mixed). Acute respiratory distress syndrome (ARDS) was found in 14 (7%) of patients out of which 13 expired. Conclusion: P. vivax which was previously considered to be benign, has now turned to be malignant. ARDS came out with the worst outcome. Early institution of dialysis and use of antimalarial drugs aggressively can result in better prognosis.