TY - JOUR

T1 - Cardiopulmonary alterations by ultrasound in a patient with uncomplicated mixed malaria infection

T2 - a case report from the Amazon Basin

AU - Wegener, Alma

AU - Lima, Karine O.

AU - Holm, Anna E.

AU - Gomes, Laura C.

AU - Matos, Luan O.

AU - Vieira, Isabelle V. M.

AU - Souza, Rodrigo Medeiros

AU - Farias Marinho, Claudio Romero

AU - Vestergaard, Lasse S.

AU - Biering-Sorensen, Tor

AU - Silvestre, Odilson M.

AU - Brainin, Philip

PY - 2021

Y1 - 2021

N2 - BackgroundInformation on cardiopulmonary complications in clinical malaria is sparse and diagnosis may be difficult in resource-limited areas due to lack of proper diagnostic tools and access to medical care. A case of pericardial effusion and pulmonary alterations assessed by ultrasound in a patient with uncomplicated mixed malaria infection is described.Case presentationA previously healthy 23-year-old male from the Amazon Basin was diagnosed with mixed infection of Plasmodium vivax and Plasmodium falciparum by peripheral blood smear. The patient presented with mild malaria symptoms without signs of severe malaria, but reported moderate chest pain and shortness of breath. Laboratory analyses revealed thrombocytopenia and anemia. The electrocardiogram had PR depressions and bedside ultrasound of the cardiopulmonary system showed pericardial effusion (18 mm) accompanied by multiple B-lines in the lungs, identified as vertical artifacts extending from the pleural line. Cardiac biomarkers were normal. The patient was treated according to national guidelines for malaria and suspected pericarditis, respectively. At follow-up on day 5, the pericardial effusion (9mm) and B-lines had markedly decreased. By day 21 the patient was asymptomatic, had completed the treatment, and the electrocardiogram and ultrasound findings had normalized.ConclusionsThis case report highlight the usefulness of bedside ultrasound to identify cardiopulmonary involvement in patients with uncomplicated malaria and relevant symptoms.

AB - BackgroundInformation on cardiopulmonary complications in clinical malaria is sparse and diagnosis may be difficult in resource-limited areas due to lack of proper diagnostic tools and access to medical care. A case of pericardial effusion and pulmonary alterations assessed by ultrasound in a patient with uncomplicated mixed malaria infection is described.Case presentationA previously healthy 23-year-old male from the Amazon Basin was diagnosed with mixed infection of Plasmodium vivax and Plasmodium falciparum by peripheral blood smear. The patient presented with mild malaria symptoms without signs of severe malaria, but reported moderate chest pain and shortness of breath. Laboratory analyses revealed thrombocytopenia and anemia. The electrocardiogram had PR depressions and bedside ultrasound of the cardiopulmonary system showed pericardial effusion (18 mm) accompanied by multiple B-lines in the lungs, identified as vertical artifacts extending from the pleural line. Cardiac biomarkers were normal. The patient was treated according to national guidelines for malaria and suspected pericarditis, respectively. At follow-up on day 5, the pericardial effusion (9mm) and B-lines had markedly decreased. By day 21 the patient was asymptomatic, had completed the treatment, and the electrocardiogram and ultrasound findings had normalized.ConclusionsThis case report highlight the usefulness of bedside ultrasound to identify cardiopulmonary involvement in patients with uncomplicated malaria and relevant symptoms.

KW - Malaria

KW - Heart disease

KW - Pericardial effusion

KW - Pericarditis

KW - Echocardiography

KW - Lung ultrasound

KW - INVOLVEMENT

U2 - 10.1186/s12936-021-03861-5

DO - 10.1186/s12936-021-03861-5

M3 - Journal article

C2 - 34321001

VL - 20

JO - Malaria Journal

JF - Malaria Journal

SN - 1475-2875

IS - 1

M1 - 330

ER -