Severe malaria can be seen with Plasmodium falciparum, Plasmodium vivax, mixed infections and other malaria species. Gupta et al listed clinical findings the indicate the presence of severe malaria. The authors are from Sardar Patel Medical College and PBM Hospital in India.
Patient selection: positive for malaria
Indicators of severe malaria (after exclusion of other causes):
(1) longer duration of fever (> 10 days)
(2) marked tiredness
(3) marked chills
(4) nausea and vomiting
(5) jaundice
(6) oliguria
(7) altered sensorium
(8) giddiness
Key predictors of a poor prognosis in a patient with severe malaria:
(1) renal failure
(2) multiple organ failures
(3) decreased Glasgow coma scale (GCS)
Other findings suggesting poor prognosis:
(1) severe anemia
(2) high parasite density
(3) severe thrombocytopenia
(4) leukocytosis
(5) hyperbilirubinemia
(6) elevated liver function tests
(7) increased SOFA score
(8) increased APACHE II score
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