Severe Plasmodium vivax Malaria in a 60-Year-Old Man: A Case Report with Acute Renal and Respiratory Involvement

Najafi, Ahmad

doi:10.48307/FMSJ.2026.30.4.501

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Volume 30, Issue 4 (Bimonthly 2026)

Feyz Med Sci J 2026, 30(4): 501-510

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Severe Plasmodium vivax Malaria in a 60-Year-Old Man: A Case Report with Acute Renal and Respiratory Involvement

Ahmad Najafi ^*

Department of Infectious Disease, Faculty of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran , najafiahmad1976@gmail.com

Abstract: (416 Views)

Background and Aim: Plasmodium vivax malaria is traditionally considered less severe than P. falciparum malaria; however, it can cause severe and life-threatening complications. We report a case of severe P. vivax malaria with multi-organ involvement and concurrent COVID-19 infection.
Case Presentation: A 60-year-old man from Afghanistan presented to Shahid Beheshti Hospital, Kashan, Iran, with a 26-day history of fever, chills, jaundice, dark urine, and progressive weakness. P.vivax malaria was confirmed by peripheral blood smear. On admission, the patient had unstable vital signs, jaundice, splenomegaly, and multiple petechiae. Laboratory findings revealed severe thrombocytopenia, hyperbilirubinemia, and impaired renal function (creatinine, 2.1 mg/dL). Despite initial treatment with chloroquine, his condition deteriorated, with respiratory failure and altered mental status requiring endotracheal intubation and intensive care. The patient also tested positive for COVID-19. Treatment included intravenous artesunate, blood transfusion, and supportive care. After stabilization, primaquine was administered for 14 days. Following seven days of intensive care, the patient was successfully extubated and showed clinical improvement. He was discharged in stable condition with follow-up recommendations.
Conclusion: This case highlights the potential of P.vivax to cause severe malaria with multi-organ involvement, including acute renal and respiratory complications. Early diagnosis, timely antimalarial treatment, and multidisciplinary care are essential for managing severe cases. Concurrent COVID-19 infection may further complicate diagnosis and treatment.

Keywords: Plasmodium vivax, Severe malaria, Acute renal failure, Respiratory failure, COVID-19, Case report

Type of Study: Case Report | Subject: General
Received: 2026/02/23 | Revised: 2026/10/6 | Accepted: 2026/08/10 | Published: 2026/08/23

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Najafi A. Severe Plasmodium vivax Malaria in a 60-Year-Old Man: A Case Report with Acute Renal and Respiratory Involvement. Feyz Med Sci J 2026; 30 (4) :501-510
URL: http://feyz.kaums.ac.ir/article-1-5508-en.html

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