A patient with Plasmodium vivax malaria may develop respiratory complaints in addition to fever.
Mechanisms:
(1) sequestration of parasitized erythrocytes within the lung vasculature by adhering to endothelial cells
(2) alveolar-capillary inflammation following treatment
Clinical manifestations:
(1) cough
(2) tachypnea (with respiratory rate > 24 breaths per minute)
(3) chest crackles (rales)
(4) normal spirometric studies (FEV1, FVC)
(5) a decrease in diffusion capacity of carbon monoxide (DLco)
(6) decrease in oxygen saturation with treatment
Severe cases may develop acute respiratory distress syndrome (ARDS) with noncardiogenic pulmonary edema.
Differential diagnosis:
(1) acute upper respiratory infection
(2) pneumonia
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Specialty: Infectious Diseases
