ABSTRACT
Plasmodium vivax [Pv] malaria is being increasingly recognized as a cause of severe malaria in children. To describe the various severe manifestations associated with vivax malaria by retrospective analysis of records. Children between the ages of 0 and 18 years with a confirmed diagnosis of Pv malaria monoinfection done by peripheral blood film [PBF] and/or rapid diagnostic test [RDT] admitted between June and September 2009 were included. Their clinical, hematological and biochemical manifestations were analyzed. Twenty-three patients of Pv malaria were retrospectively analyzed. Thrombocytopenia was present in 22 [96%] patients with counts less than 50,000/ micro L in 9 patients. Severe anemia [hgb < 5 mg/dl] was present in 8 [34%] patients. Cerebral malaria was present in 3 patients. Liver enzymes were elevated [>3 times normal] in 4 [17.3%] patients while jaundice [bilirubin > 2.5 mg/dl] was present in 2 patients [total bilirubin 5.2 mg/dl and 14.3 mg/dl]. Renal dysfunction [creatinine > 3 mg/dl] was present in 6 [26%] patients with 2 patients showing severely deranged renal functions [blood urea 168 mg/dl, 222 mg/dl and serum creatinine 5.0 mg/dl, 5.6 mg/dl, respectively]. Hypernatremia was present in one patient. One patient expired within 12 h of presentation because of severely deranged hepatic and renal dysfunction. Pv malaria can lead to unusual and fatal complications. All new guidelines should include "Severe Vivax malaria" as a clinical entity. Further research into the etiopathogenesis and treatment would be important