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VOLUME 21 , ISSUE 6 ( 2017 ) > List of Articles


Fatal postoperative hemolysis due to severe falciparum malaria

Nambiraj Konar

Keywords : Anesthesia, cyclophosphamide, falciparum, general, hemolysis, malaria, thrombocytopenia

Citation Information : Konar N. Fatal postoperative hemolysis due to severe falciparum malaria. Indian J Crit Care Med 2017; 21 (6):391-393.

DOI: 10.4103/ijccm.IJCCM_338_16

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2017; The Author(s).


A 60-year-old apparently healthy female patient underwent mastectomy for breast cancer. She had sinus tachycardia and no other abnormal finding in the preoperative period. However, the immediate postoperative course was stormy with the development of anemia, thrombocytopenia, hemolysis, and renal failure with severe metabolic acidosis. Peripheral blood smear revealed the presence of ring forms of Plasmodium falciparum. Multiorgan failure and death occurred within 36 h of surgery in spite of initiation of antimalarial agents. Diagnosis of malaria should be kept in mind in the event of development of sudden unexplained deterioration or multiorgan dysfunction associated with thrombocytopenia, hemolysis, and severe metabolic acidosis, even in previously asymptomatic patients, especially in residents or recent travelers of the malaria-endemic area.

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