Malaria - the Master Masquerader

Severe orthostatic hypotension in otherwise uncomplicated Plasmodium vivax infection

“…Hypotension meeting World Health Organization criteria for severe malaria has been reported in several case series of adult vivax malaria [ 11 – 14 ]. However, orthostatic hypotension which has been previously well documented during an acute P. falciparum infection [ 9 ] has been rarely described in P. vivax [ 1 – 3 ]. This case report describes a 5-day episode of orthostatic hypotension in a non-immune Thai woman with vivax malaria after start of treatment with chloroquine and after adequate fluid resuscitation.…”

“…Impaired autonomic control of postural homeostasis resulting in orthostatic hypotension has been described in falciparum malaria, but severe orthostatic intolerance in Plasmodium vivax has been rarely reported [ 1 – 3 ]. Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mmHg or a decrease in diastolic blood pressure of 10 mmHg within 3 min after a change from a reclining to upright posture, together with associated symptoms [ 4 ].…”

Cutaneous Manifestations of Malaria and Their Prognostic Windows: A Narrative Review

“…A classic presentation of febrile urticaria in the pediatric population is the appearance of wheals associated with edema of underlying subcutaneous tissues. This skin manifestation is believed to result from the malarial subtypes P. falciparum and Plasmodium vivax [ 9 , 10 ]. It is thought that this skin manifestation is antigen-implicated - involving IgE mediation and/or mast cell degranulation processes [ 9 ].…”

“…This skin manifestation is believed to result from the malarial subtypes P. falciparum and Plasmodium vivax [ 9 , 10 ]. It is thought that this skin manifestation is antigen-implicated - involving IgE mediation and/or mast cell degranulation processes [ 9 ]. Scientists speculate that the process of Plasmodial daughter merozoites attaching to specific erythrocyte receptors yields an antigenic response by altering the membranes of red blood cells.…”

“…Scientists speculate that the process of Plasmodial daughter merozoites attaching to specific erythrocyte receptors yields an antigenic response by altering the membranes of red blood cells. The resulting increase in the antigenicity of the red blood cells may lead to the degranulation of large stores of mast cells, causing red, itchy wheals [ 9 ]. In these patients, the resulting inflammatory markers released lead to the classic presentation of bronchospasm, shock, and angioedema [ 10 ].…”