ABSTRACT
To evaluate different hematological changes in patients with malaria and to establish a possible role of Plasmodium species in the pathogenesis of these changes. Hematological changes were prospectively studied in randomly selected patients, immediately on admission and on a daily basis after starting anti-malarial treatment. Infectious Diseases Hospital, Kuwait, during the year 2004. The study enrolled 103 patients with malaria, [37 infected with Plasmodium falciparum, 34 infected with Plasmodium vivax, and 32 infected with both species i.e., mixed infections]. Antimalarial drugs Beside history taking, clinical examination, and routine laboratory work, thick and thin blood films were prepared and examined from all patients for defining the species involved. In addition, blood picture [red and white blood cells, platelets, and reticulocytes] was studied in all patients. Anemia and thrombocytopenia were the two most important hematological abnormalities seen in cases of acute malaria infection. The degree of anemia was related more to P. falciparum infection, while, thrombocytopenia was associated with P. vivax infection and mixed infections. Hematological changes were mild in the first 24 hours, but continued to deteriorate for few days after anti-malarial therapy. One P. falciparum infection was associated with severe hematologic abnormalities, disseminated intravascular coagulopathy [DIC], and acute respiratory distress syndrome [ARDS]. We recommend that subsequent checkup of blood cells and platelets are of utmost importance particularly in cases infected with P. falciparum or mixed infections