Morphologie und verlauf der fatalen malaria tropica

Fatalities connected with the most severe form of malaria (falciparum malaria) are repeatedly due to the delay in clinical diagnosis and therapy. Clinical and pathological data from 11 patients showed typical and atypical features of the infection. In all cases infection was acquired in African countries and only two patients had a history of chemoprophylaxis. The clinical course of the disease was short with a median of 9.5 days. Death occurred due to multi-organ failure with cerebral malaria, disseminated intravascular coagulation, lung oedema and acute renal failure as the most commonly found manifestations. Of the patients three died because of complications due to splenomegaly, one patient had toxic myocarditis and in one case liver failure occurred. In six cases malaria was not suspected before admission to hospital, while in two cases "sudden death" occurred without preceding hospitalisation. In one case the malaria was classified as an occupational disease. The data show the fatal process of falciparum malaria if therapy is delayed with a short clinical course and complex organ failure.