Acute Colonic Pseudo-Obstruction in Severe Falciparum Malaria: A Case Report

• Published in: Journal of medical cases Vol. 12; no. 12; pp. 481 - 484
• Main Authors: Yao, Peng Fei, Zhang, Peng Jiang, Dong, He, Sun, Yang
• Format: Journal Article
• Language: English
• Published: Canada Elmer Press 01.12.2021
• Subjects: Case Report; Malaria; Severe; Acute colonic pseudo-obstruction
• ISSN: 1923-4155; 1923-4163
• DOI: 10.14740/jmc3801

Severe falciparum malaria is associated with multiple organ dysfunctions. The most manifestations of severe falciparum malaria are cerebral malaria, acute lung injury, and acute kidney injury. Acute colonic pseudo-obstruction is extremely rare. Early recognition and management are essential because a delay in diagnosis is associated with substantial morbidity and mortality. A 29-year-old peacekeeper in the Democratic Republic of Congo (DRC) was diagnosed as severe falciparum malaria with high-grade fever, jaundice, electrolyte disturbance, and thrombocytopenia. Although adequate antimalaria therapy with intramuscular artemether was given, the patient had persistent fever, shallow and fast breathing, and abdominal pain. Investigations suggested a diagnosis of acute colonic pseudo-obstruction. Antimalarial therapy was continued with intravenous artesunate. And rectal decompression and fasting were taken. Soon, symptoms of colonic obstruction mitigated. And the patient was cured and discharged. Acute colonic pseudo-obstruction should be considered for severe malaria patients with abdominal distention and pain. The early diagnosis and proper management of the patient with severe malaria complicated with acute colonic pseudo-obstruction are the keys to a good prognosis.