Patient selection: Plasmodium vivax
Criteria for severe vivax malaria:
(1) requires admission to the intensive care unit (ICU)
(2) one or more of the following (indicative of organ failure):
(2a) shock (systolic blood pressure < 80 mm Hg, resistant to fluid resuscitation)
(2b) acute lung injury (ARDS and/or pulmonary edema)
(2c) acute renal failure (serum creatinine > 3 mg/dL)
(2d) coma (Glasgow coma score < 9, cerebral malaria)
(2e) severe anemia (hemoglobin < 5 g/dL, not explained by other cause)
(3) exclusion of Plasmodium falciparum or other cause
Other manifestations can be seen in non-critical illness but may become significant if severe malaria is present:
(1) jaundice with serum total bilirubin > 3 mg/dL
(2) hypoglycemia (blood glucose < 40 mg/dL)
(3) thrombocytopenia and/or coagulopathy
Patients severe vivax malaria may experience significant:
(1) pain
(2) malaise
(3) disability/debilitation
(4) in pregnant women, fetal loss, preterm birth and other complications
