Severe orthostatic hypotension in otherwise uncomplicated Plasmodium vivax infection

Abstract Impaired autonomic control of postural homeostasis resulting in orthostatic hypotension has been described in falciparum malaria. However, severe orthostatic intolerance in Plasmodium vivax has been rarely reported. A case of non-immune previously healthy Thai woman presenting with P. vivax...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Chaisith Sivakorn, Polrat Wilairatana, Srivicha Krudsood, Marcus J. Schultz, Tachpon Techarang, Khanittha Kheawsawaung, Arjen M. Dondorp
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2021
Subjects:
Plasmodium vivax
Orthostatic hypotension
Shock
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1186/s12936-020-03564-3
https://doaj.org/article/d3162e2f35a145bc884570311d8df294
Description
Summary:Abstract Impaired autonomic control of postural homeostasis resulting in orthostatic hypotension has been described in falciparum malaria. However, severe orthostatic intolerance in Plasmodium vivax has been rarely reported. A case of non-immune previously healthy Thai woman presenting with P. vivax infection with well-documented orthostatic hypotension is described. In addition to oral chloroquine and intravenous artesunate, the patient was treated with fluid resuscitation and norepinephrine. During hospitalization, her haemodynamic profile revealed orthostatic hypotension persisting for another three days after microscopic and polymerase chain reaction confirmed parasite clearance. Potential causes are discussed.

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