Falciparum Long-term Outcomes

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QUESTION

My husband was admitted to ICU for 22% falciparum parasite load (with some mild kidney and liver failure, as well as low blood pressure) after being overseas two weeks earlier.

They treated him with IV artesunate and oral Malarone and an exchange transfusion, and discharged him after a week, as his kidneys had improved and so had his blood pressure, and he wasn’t yellow anymore. He never went unconscious.

He’s still quite short of breath and having a challenging time climbing stairs which hasn’t really improved over the past week. It’s not outright respiratory distress, as he was having this in the hospital as well and never actually needed oxygen. He’s also still feeling warm (though no documented fevers).

I am wondering about: a) Whether testing for recrudescence is useful almost two weeks after symptoms started b) how long this shortness of breath is anticipated to last (and is it secondary to a mild transfusion reaction, as his chest Xrays were always normal in the hospital) and c) will there be long-term sequelae I should be aware of (as I can’t find anything except for “falciparum infection has poor prognosis if not treated promptly’) and d) what are his risks of becoming this sick again?

ANSWER

It sounds as if your husband received good care and that you are very well informed which is excellent.  Recrudescence can occur up to 28 days after initial infection but it isn’t common if the above treatment was given.  One of the side effects of malaria is anemia, and this can cause fatigue and breathlessness.  My hunch is that he probably is anemic and should be eating iron rich foods (meats, greens) and taking an iron supplement. It is best to check with your primary care physician who can order a simple blood test to check for anemia and advise you on supplements and nutrition.  There shouldn’t be a poor prognosis in the long term for people treated and recovered from falciparum malaria. I hope this helps.

Effects of Malaria

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QUESTION

what are effects of malaria?

ANSWER

If a person becomes infected with malaria, they may start to experience the symptoms of the disease. These include high fever, aches, chills, nausea, headache, and sometimes more severe manifestations, such as severe anemia, impaired consciousness and even coma or death. These latter severe effects are more commonly associated with Plasmodium falciparum infection, the most deadly form of malaria.

After Malaria: Low Iron, Chest Pains

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QUESTION

I got malaria in Ghana in February 2012 and was treated for it and recovered within 10 days. I had no problem or illness after that. Returned to USA late May of 2012 healthy able to run 4 or 5 miles a day and be active. About 3 or 4 weeks later suddenly developed shortness of breath, chest pains with hunger and thirst. Have seen 5 different doctors and had extensive heart, lung, digestive, blood tests, thyroid, diabetis etc. All have come out okay except for recent blood test showing some very low iron levels (Iron always Ok previously). Still having chest pain, breathing problems, thirst and hunger. Can’t run more than a block now. Could this be related to malaria or similar illness from Ghana? Any suggestions on what it could be and what doctors should be looking for as the doctors seemed stumped? Has anyone else had similar problems after having malaria? I appreciate any assistance that you can provide.

ANSWER

Sorry to hear about your current situation.  My advice is to treat your low iron levels. There are cases where patients who have been cured of malaria still develop severe anemia, and it is conceivable that some of your symptoms such as shortness of breath, fatigue, and chest pain are caused by  severe anemia.  Treating anemia can often show dramatic results.  Oral iron tablets are effective as well as eating iron-rich foods (meat, greens such as spinach, dried apricots, beans etc).  If you don’t feel better in a couple of weeks, I suggest you go back to the clinic for further discussion with your health provider.

Malaria and Menstrual Cycle

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QUESTION

Does malaria affect menstrual cycle?

ANSWER

Malaria usually does not last very long—people usually seek diagnosis and treatment within a few days (since symptoms can be severe) and then treatment and recovery follow swiftly, within another few days (100% recovery may take longer, up to a few weeks). Moreover, malaria does not usually interfere with reproductive organs or hormone production. As such, malaria usually does not interfere with the menstrual cycle. However, malaria can result in anemia; many women also experience mild anemia during and after menstruation, and it is possible that this iron deficiency could be exacerbated by malaria infection.

What are the symptoms of malaria?

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QUESTION

What are the symptoms of malaria?

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells.

Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

Is Malaria Related to Chronic Fatigue and Hair Loss?

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QUESTION

I was in Ghana one year ans 6 months ago when I contracted malaria. I was hospitalised for one day and treated with coartem for 3 days. I was treated with antibiotics for typhoid also however I had been vaccinated against this prior to my trip.

Since my return I began loosing significant amount of hair from my head and suffer fatigue after small amounts of exercise and work. I never suffered from these ailments before having malaria. I consulted my doctor who suggested multivitamins which have reduced the hair loss however the fatigue persists.

I wish to know is the fatigue related to malaria and is there anything I can do to improve this problem. Generally I am fit and healthy, eat well and engage in regular exercise.

ANSWER

It is very unusual for malaria to have any long term health effects once the infection has been successfully treated. It is possible that you are suffering from some residual anemia, which can be caused by malaria, though is more likely due to iron deficiency in your diet. Given that you clearly were deficient for other nutrients (as shown by the positive effects seen when you started taking multivitamins), I would think that if you do have anemia, it is more likely due to diet than anemia! Try asking for a blood test for anemia from your doctor, and if you are indeed anemic, you can look into taking iron supplements as well, or try to include iron-rich foods in your diet.

Malaria Symptoms

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QUESTION

WHAT ARE THE SYMPTOMS?

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

Malaria Medication Side Effects

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QUESTION

My mother is an old patient of arthritis. She has also had a long stint with asthma and tuberculosis. She has presently been diagnosed with urine infection but was treated with malaria medicines artesunate and primaquine phosphate.

What side effects could she possibly develop by wrong administration of malaria medicines?
ANSWER

Luckily there are few major side effects associated with either artesunate or primaquine. Mild side effects of the former include ones similar to malaria: nausea, headache, loss of appetite and vomiting. Side effects of primaquine are very similar to this, but can also include intense itching and anemia in some people (mainly of Mediterranean or African descent). The main thing to be aware of with primaquine is that it can be dangerous for people with G6DP deficiency, so patients should be tested for this before taking primaquine.

Malaria and Anemia

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QUESTION

How does malaria cause anemia?

ANSWER

Anemia is the result of a decrease in the number of red blood cells in the blood. Malaria specifically attacks red blood cells, invading them and then undergoing multiple cycles of reproduction inside them. Once replication has been completed, the malaria parasites burst out of the red blood cell, destroying it in the process. Over the course of an infection, this can destroy many red blood cells, resulting in anemia in the patient.