Severe malaria can cause acute multisystem organ failure.
Clinically, the presence of hyperparasitaemia and/or hypoglycaemia are useful markers of severity, given the ease of recognition prior to the development of acute organ failure.
In patients with malaria, these features should prompt immediate action to prevent further progression of disease!
| Impaired consciousness or seizures |
| Renal impairment (oliguria <0.4 ml/kg bodyweight per hour or creatinine >265 µmol/l) |
| Acidosis (pH < 7.3) |
| Hypoglycemia (<2.2 mmol/l) |
| Pulmonary oedema or acute respiratory distress syndrome (ARDS) |
| Haemoglobin ≤80 g/L |
| Spontaneous bleeding/disseminated intravascular coagulation |
| Shock (BP < 90/60 mmHg) |
| Haemoglobinuria (without G6PD deficiency) |
| Parasitaemia >10% |