Sub-acute intestinal obstruction – a rare complication of Plasmodium falciparum malaria in an adult: a case report

Abstract

BackgroundMalaria remains a major public health problem in most tropical countries. It occasionally presents with both typical and atypical signs and symptoms. Gastrointestinal manifestations are common in malaria endemic areas but intestinal obstruction as a complication is extremely rare.Case presentationWe present the case of a 42-year-old black African man who presented with signs and symptoms of intestinal obstruction and was diagnosed as having Plasmodium falciparum malaria. He was successfully treated with both parenteral and orally administered antimalarial medication and the intestinal obstruction subsequently resolved.ConclusionWith intestinal obstruction being an important cause of morbidity and mortality, we report this case to highlight this rare complication of malaria and therefore increase physicians’ awareness and prompt diagnosis and management.

Does Malaria Cause Diarrhoea? A Systematic Review

“…Six papers reported a history of diarrhoea prior to arrival at hospital (with a duration of 2 days to 4 weeks) and patients were diagnosed with either P. falciparum (n = 4), P. malariae (n = 2), or P. vivax (n = 1) malaria. One case of constipation lasting 4 days, and resolving after antimalarial treatment, was reported in a Cameroonian patient with P. falciparum malaria (70). Coinfections were frequent in this group, with schistosomiasis and leishmaniasis (71), borreliosis (72), and Salmonella Typhi (73) infections complicating the attribution of diarrhoea.…”

A case of Falciparum malaria presenting with features of functional bowel obstruction

“…One was reported by the food drug administration in 2003 [ 3 ]. It was also reported in a 42-year-old black African man [ 1 ] and an 18-month-old Indian girl [ 4 ]. Intestinal obstruction secondary to mechanical compression caused by an enlarged spleen due to malaria has also been reported [ 5 ].…”

“…In the case of Divine Tim et al. , the patient passed a small amount of faeces 48 hours after initiation of quinine base infusion, with complete resolution of the abdominal pain, distension and bowel movements on the fourth day of hospital stay [ 1 ]. In our case, the patient passed flatus about 36 hours after starting the intravenous artesunate and he passed faeces around 48 hours with the resolution of the abdominal pain and distension.…”

“…Malaria is a fatal tropic disease that is considered one of the principal causes of death in many developing countries. The clinical presentation of malaria is variable with only 50–70% of patients presenting with classic paroxysms of fever [ 1 ]. The principal symptoms of malaria include fever, rigours, headache, sweats, anorexia, nausea and vomiting [ 1 ].…”

“…The clinical presentation of malaria is variable with only 50–70% of patients presenting with classic paroxysms of fever [ 1 ]. The principal symptoms of malaria include fever, rigours, headache, sweats, anorexia, nausea and vomiting [ 1 ]. Gastrointestinal complications due to malaria including tropical splenomegaly syndrome, gastrointestinal bleeding, splenic rupture and sub-acute intestinal obstruction have been recorded among children with complicated malaria [ 2 ].…”