ABSTRACT
BACKGROUND: Elevated serum D-dimer levels may reflect endothelial activation, which in malaria may correlate with parasite biomass and disease severity. METHODS: We performed a retrospective chart review of all non-immune travelers hospitalized with malaria during 01/2000-12/2014â¯at the Sheba Medical Center, Israel. Admission and peak D-dimer levels were compared among malaria patients, according to Plasmodium species and severity. RESULTS: Complete laboratory data was available for 94/168 travelers hospitalized with malaria, with 68.1% caused by P. falciparum. Admission D-dimer levels were significantly higher in P. falciparum malaria compared to non-falciparum malaria cases (3585⯱â¯7045 and 802⯱â¯1248â¯ng/dL respectively, pâ¯=â¯0.04). Admission D-dimer levels were higher in patients with severe compared to non-severe P. falciparum malaria (4058⯱â¯3544 & 3490⯱â¯7549â¯ng/dL), however the difference was short of statistical significance (Pâ¯=â¯0.06). Peak D-dimer levels were also significantly higher in severe and non-severe P. falciparum than in non-falciparum cases. CONCLUSIONS: In most non-immune travelers with malaria, D-dimer levels are elevated, are higher in P. falciparum malaria compared to non-falciparum malaria, and appear to increase with disease severity, probably reflecting the level of endothelial damage.