The patient is a 14-year-old Australian citizen. Two weeks before being hospitalized, the child and his family traveled to the mountainous region of Sumatra, Indonesia.
Two days before being admitted to the hospital, the child had a fever, vomited, and had loose stools several times a day. The child had been treated at a family medicine clinic and a hospital in Hanoi with a diagnosis of sepsis, but his condition did not improve. Due to the complicated course of the disease, the child was transferred to the National Children's Hospital for further treatment.
Associate Professor, Dr. Ta Anh Tuan - Head of the Department of Internal Medicine Intensive Care, who directly treated the patient, said: "The child was admitted to the hospital in a state of respiratory failure, with clear signs of jaundice, circulatory failure, renal failure, and increased inflammatory reactions. The initial diagnosis was "monitoring for sepsis, with organ failure". However, through epidemiological analysis, before the onset of the disease, the child had traveled to the mountainous area, so we suspected that the child had malaria and ordered a blood test to find malaria parasites. After 18 hours of admission, the test results showed that the child was positive for malaria parasites caused by the Plasmodium falciparum strain".
After receiving the test results, the doctors of the Internal Medicine Intensive Care Department consulted with colleagues experienced in malaria and concluded that the child had malignant malaria and multiple organ failure. Immediately, the patient was given antimalarial drugs according to the Ministry of Health's protocol. However, after 1 day of treatment, the child's condition continued to worsen, with hemolysis, kidney failure, and liver failure becoming more severe. Therefore, the doctors decided to replace plasma and continuously filter the patient's blood to support the organs, while still using antimalarial drugs.
Fortunately, after the second day of treatment, the patient overcame the critical stage, and his liver and kidney failure improved. The child continued to take anti-malarial drugs, monitored vital functions, and tested for malaria parasites daily. After 5 days of treatment, the patient's fever has gone down, his health is stable, and he is expected to be discharged in the next few days.
Assessing the success of the case, Associate Professor, Dr. Ta Anh Tuan commented: Malignant malaria is very rare in the Northern Delta region, because this is not an epidemic area, the symptoms and treatments are mainly only available in textbooks. Therefore, exploiting detailed medical history to accurately prescribe diagnostic tests, and at the same time, consulting a team to find a quick and effective treatment regimen, proactively supporting the child's organ functions is the key to successfully caring for and treating the case. If malignant malaria is not correctly diagnosed and only treated in the direction of infection, the child has a very high risk of death.
