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Modern clinical and laboratory indicators of severe Plasmodium falciparum malaria

https://doi.org/10.21518/ms2025-159

Abstract

According to WHO Report 2024, malaria is still a global health challenge, especially in Africa, Asia and South America. In the opinion of the authors, errors made in adequate assessment of clinical and laboratory indicators of P. falciparum malaria (tropical malaria) in a patient are the major reasons that can lead to a lethal disease outcome. The aim of our research was to describe the clinical and laboratory indicators of severe tropical malaria with a severe and complicated course of disease in a female patient, taking into account the analysis of data from modern scientific and medical literature, and our own experience. An abstract of the case history of patient M., 56 years old, is presented. The patient underwent medical treatment in an infectious disease hospital under the primary diagnosis of Plasmodium falciparum malaria with cerebral complications and acute renal failure, severe course of illness. She fell ill on Day 7 after her journey to Tanzania (Zanzibar Island). The disease developed in a severe, complicated form with acute renal failure, sepsis, severe anemia, bilateral polysegmental pneumonia, and nosebleeds. The parasitemia level reached 1,428,000 per microliter of blood. The treatment regimen of malaria included Coartem. Due to ongoing intensive therapy, positive changes were achieved. A stable absence of parasitemia was observed, however a peripheral edema and a high level of azotemia persisted. The patient continued to undergo treatment in the Department of Nephrology, where a significant clinical outcome in the form of decreased azotemia levels was achieved. The woman was discharged home in a satisfactory condition. The clinical case example fully reflects modern clinical and laboratory criteria for severe, complicated tropical malaria, and demonstrates rapid development of serious complications as a result of late admission to hospital. It represents a practical interest not only for infectious disease experts, but also for therapists, nephrologists, neurologists, resuscitationists and physicians of other specialties.

About the Authors

A. A. Erovichenkov
Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute); Russian Medical Academy of Continuous Professional Education
Russian Federation

Alexander A. Erovichenkov, Dr. Sci. (Med.), Professor, Head of the Clinical Department, Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute); Professor of the Department of Infectious Diseases, Russian Medical Academy of Continuous Professional Education

8, Bldg. 1, Settlement of the Institute of Poliomyelitis, Moscow, 117218,

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993


D. D. Arutyunova
Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute)
Russian Federation

Daria D. Arutyunova, Cand. Sci. (Med.), Senior Researcher, Clinical Department

8, Bldg. 1, Settlement of the Institute of Poliomyelitis, Moscow, 117218


N. Yu. Pshenichnaya
Russian Medical Academy of Continuous Professional Education; Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
Russian Federation

Natalia Yu. Pshenichnaya, Dr. Sci. (Med.), Professor, Head of the Department of Infectious Diseases, Russian Medical Academy of Continuous Professional Education; Deputy Director for Clinical and Analytical Work, Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

3a, Novogireevskaya St., Moscow, 111123


G. V. Gopatsa
Russian Medical Academy of Continuous Professional Education; Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; Infectious Disease Clinical Hospital No. 1
Russian Federation

Galina V. Gopatsa, Cand. Sci. (Med.), Associate Professor in the Division of Infectious Diseases, Russian Medical Academy of Continuous Professional Education; Senior Researcher of the Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; Head of Department, Department, Infectious Disease Clinical Hospital No. 1.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

3a, Novogireevskaya St., Moscow, 111123,

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367


A. A. Sokhlikov
Infectious Disease Clinical Hospital No. 1
Russian Federation

Aleksey A. Sokhlikov, Head of the Center for Anesthesiology and Resuscitation

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367


E. A. Liapeikova
Infectious Disease Clinical Hospital No. 1
Russian Federation

Ekaterina A. Liapeikova, Head of Department

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367


S. K. Pylaeva
Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute); Pirogov Russian National Research Medical University
Russian Federation

Sofia K. Pylaeva, Junior Researcher, Clinical Department, Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute); Head of the Training Laboratory of the Department of Infectious Diseases in Children, Pirogov Russian National Research Medical University

8, Bldg. 1, Settlement of the Institute of Poliomyelitis, Moscow, 117218,

1, Ostrovityanov St., Moscow, 117997


N. F. Frolova
City Clinical Hospital No. 52; Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko, the Russian University of Medicine
Russian Federation

Nadiya F. Frolova, Cand. Sci. (Med.), Deputy Chief Physician for Nephrological Care, Head of the Interdistrict Nephrology Center, City Clinical Hospital No. 52; Associate Professor of the Department of Nephrology, Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine

3, Pexotnaya St., Moscow, 123182,

1AC.4, Kuskovskaya St. Moscow, 111398


L. V. Kudryavtseva
State Moscow Scientific and Practical Center for Laboratory Research
Russian Federation

Larisa V. Kudryavtseva, Dr. Sci. (Med.), Head of Clinical Diagnostic Laboratory

49, Bldg. 1, Orekhovy Boulevard, Moscow,115580


M. A. Ilina
Infectious Disease Clinical Hospital No. 1; Pirogov Russian National Research Medical University
Russian Federation

Maria A. Ilina, Acting Deputy Chief Physician for Outpatient and Polyclinic Work, Head of Moscow Center for Chronic Infectious Diseases, TickBorne Infections, Travel Medicine and Preventive Vaccination,  Infectious Disease Clinical Hospital No. 1; Assistant of the Department of Infectious Diseases in Children, Pirogov Russian National Research Medical University

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367,

1, Ostrovityanov St., Moscow, 117997


E. V. Kardanova
Infectious Disease Clinical Hospital No. 1; Pirogov Russian National Research Medical University
Russian Federation

Elena V. Kardanova, Cand. Sci. (Med.), Head of the Organizational and Methodological Department for Infectious Diseases,  Infectious Disease Clinical Hospital No. 1; Associate Professor of the Department of Infectious Diseases and Epidemiology, Pirogov Russian National Research Medical University

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367,

1, Ostrovityanov St., Moscow, 117997


N. N. Zvereva
Pirogov Russian National Research Medical University
Russian Federation

Nadezda N. Zvereva, Cand. Sci. (Med.), Associate Professor of the Department of Infectious Diseases in Children, Faculty of Pediatrics

1, Ostrovityanov St., Moscow, 117997


N. A. Antipyat
Infectious Disease Clinical Hospital No. 1
Russian Federation

Natalya A. Antipyat, Deputy Chief Physician for Medical Affairs

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367


I. N. Tyurin
Infectious Disease Clinical Hospital No. 1; Pirogov Russian National Research Medical University
Russian Federation

Igor N. Tyurin, Dr. Sci. (Med.), Chief  Physician, Infectious Disease Clinical Hospital No. 1; Russia; Associate Professor of the Department of Anesthesiology and Reanimatology, Pirogov Russian National Research Medical University

63, Bldg. 2, Volokolamskoe Shosse, Moscow, 125367,

1, Ostrovityanov St., Moscow, 117997

 


A. A. Ishmukhametov
Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute); Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Aydar A. Ishmukhametov, Аcademician RAS, Dr. Sci. (Med.), Professor, Director General, Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute); Head of the Department of Organization and Technology of Immunobiological Preparations Production, Sechenov First Moscow State Medical University (Sechenov University)

8, Bldg. 1, Settlement of the Institute of Poliomyelitis, Moscow, 117218,

8, Bldg. 2, Trubetskaya St., Moscow, 119991


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Review

For citations:

Erovichenkov AA, Arutyunova DD, Pshenichnaya NY, Gopatsa GV, Sokhlikov AA, Liapeikova EA, Pylaeva SK, Frolova NF, Kudryavtseva LV, Ilina MA, Kardanova EV, Zvereva NN, Antipyat NA, Tyurin IN, Ishmukhametov AA. Modern clinical and laboratory indicators of severe Plasmodium falciparum malaria. Meditsinskiy sovet = Medical Council. 2025;(5):206-215. (In Russ.) https://doi.org/10.21518/ms2025-159

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