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April 1972

Acute Renal Insufficiency Due to Falciparum MalariapReview of 42 Cases

Author Affiliations

Nashville, Tenn; USA, Washington, DC

From the 629th Medical Detachment (Dialysis Unit), Third Field Hospital, Saigon, Vietnam; Department of Medicine, Tachikawa Air Force Base Hospital, Japan; and Renal Dialysis Service, Department of Medicine, Walter Reed General Hospital, and Department of Nephrology, Walter Reed Army Institute of Research, Washington, DC. Dr. Stone is presently with Vanderbilt University School of Medicine and the Nashville Veterans Administration Hospital, Nashville, Tenn. Dr. Hanchett is now with the Veterans Administration Hospital, Pittsburgh. Dr. Knepshield is now with the Walter Reed General Hospital, Washington, DC.

Arch Intern Med. 1972;129(4):620-628. doi:10.1001/archinte.1972.00320040096013

Falciparum malaria has become a major military health problem in Southeast Asia. Renal, cerebral, and pulmonary involvement are uncommon but potentially lethal complications of this disease. Forty-two soldiers with acute renal insufficiency due to falciparum malaria acquired in Vietnam comprise this series. Twelve (29%) died, usually of respiratory failure or cerebral malaria. Delays in diagnosis and treatment were frequent in fatal cases. The establishment of a dialysis punit in Vietnam and the development of an acceptable chemotherapeutic regimen has decreased the initial mortality of 50% to the present 14%. Two patients are presented to illustrate the difficulties encountered in US civilian hospitals when soldiers recently returned from Vietnam become ill with complicated falciparum malaria.