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.
William J. pStone, James E. Hanchett, James H. Knepshield. Acute Renal Insufficiency Due to Falciparum MalariapReview of 42 Cases. Arch Intern Med. 1972;129(4):620–628. doi:10.1001/archinte.1972.00320040096013