warfarin and Malaria--Falciparum

Malaria is a common health problem in India and contributes about 80% of the total cases in South East Asia. Falciparum malaria is known for its various complications, including cerebral malaria, severe anaemia, acute renal failure, acute lung injury, jaundice (and hepatic involvement), hypoglycaemia and circulatory collapse. We hereby report on a young male who was suffering from complicated falciparum malaria, and had purpura fulminans along with laboratory features suggestive of disseminated intravascular coagulation. He was treated with intravenous (IV) artesunate, low molecular weight heparin followed by warfarin in addition to IV fluids to which he showed gradual response. We have presented this case to make others vigilant enough to suspect malaria in differential diagnosis of purpura fulminans.

Topics: Anticoagulants; Artemisinins; Artesunate; Disseminated Intravascular Coagulation; Heparin; Humans; India; Lower Extremity; Malaria, Falciparum; Male; Purpura Fulminans; Treatment Outcome; Warfarin; Young Adult