{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:32:47Z","timestamp":1783135967105,"version":"3.54.6"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Direcci\u00f3n General de Investigaciones of Universidad Santiago de Cali","award":["DGI-01-2025"],"award-info":[{"award-number":["DGI-01-2025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Plasmodium falciparum malaria remains a major cause of morbidity and mortality, particularly in endemic regions. We report the case of a 21-year-old male with recent travel to an endemic area (Guapi, Colombia), who presented with febrile symptoms, severe respiratory distress, and oxygen saturation below 75%, necessitating orotracheal intubation. During the procedure, he developed pulseless electrical activity cardiac arrest, achieving return of spontaneous circulation after advanced resuscitation. Diagnosis was confirmed by thick blood smear, demonstrating P. falciparum infection. The patient progressed to multiorgan failure, including acute respiratory distress syndrome with capillary leak pulmonary edema, refractory distributive shock, acute kidney injury with severe hyperkalemia, and consumptive thrombocytopenia. Management included invasive mechanical ventilation, vasopressor support, sedation-analgesia, neuromuscular blockade, methylene blue, unsuccessful hemodialysis due to hemorrhagic complications, and platelet transfusions. Despite these interventions, the patient experienced a second cardiac arrest and died. This case highlights the severity and rapid progression of severe malaria with multisystem involvement, underscoring the critical importance of early diagnosis and intensive multidisciplinary management. It also emphasizes the need for preventive strategies for travelers to endemic areas and the development of clinical protocols to improve outcomes in complicated malaria.<\/jats:p>","DOI":"10.3390\/life15081201","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:05:47Z","timestamp":1753711547000},"page":"1201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Severe Malaria Due to Plasmodium falciparum in an Immunocompetent Young Adult: Rapid Progression to Multiorgan Failure"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4251-8517","authenticated-orcid":false,"given":"Valeria","family":"Sanclemente-Cardoza","sequence":"first","affiliation":[{"name":"Faculty of Health, School of Public Health, Universidad del Valle, Cali 760043, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-1214","authenticated-orcid":false,"given":"Harold Andr\u00e9s","family":"Pay\u00e1n-Salcedo","sequence":"additional","affiliation":[{"name":"Faculty of Health, Universidad Santiago de Cali, Cali 760035, Colombia"},{"name":"Health and Movement Research Group, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Estela-Zape","sequence":"additional","affiliation":[{"name":"Faculty of Health, Universidad Santiago de Cali, Cali 760035, Colombia"},{"name":"Health and Movement Research Group, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1086\/589288","article-title":"Editorial commentary: Mortality associated with severe Plasmodium falciparum malaria increases with age","volume":"47","author":"Olliaro","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_2","unstructured":"Organizaci\u00f3n Mundial de la Salud (OMS) (2025, June 09). Malaria. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/malaria."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Instituto Nacional de Salud (INS) (2025). Bolet\u00edn Epidemiol\u00f3gico Malaria Semana 17-SIVIGILA, Instituto Nacional de Salud (INS).","DOI":"10.33610\/23576189.2025.17"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/cc2183","article-title":"Clinical review: Severe malaria","volume":"7","author":"Trampuz","year":"2003","journal-title":"Crit. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1111\/cmi.12183","article-title":"Malaria\u2019s deadly grip: Cytoadhesion of Plasmodium falciparum-infected erythrocytes","volume":"15","author":"Smith","year":"2013","journal-title":"Cell. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0163-7258(03)00060-3","article-title":"The pathophysiology of falciparum malaria","volume":"99","author":"Clark","year":"2003","journal-title":"Pharmacol. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.5334\/gh.789","article-title":"Cardiovascular Findings in Severe Malaria: A Review","volume":"15","author":"Wooldridge","year":"2020","journal-title":"Glob. Heart"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4269\/ajtmh.14-0841","article-title":"Investigating the Pathogenesis of Severe Malaria: A Multidisciplinary and Cross-Geographical Approach","volume":"93","author":"Wassmer","year":"2015","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_9","unstructured":"Organizaci\u00f3n Panamericana de la Salud (2025, June 09). Malaria, Available online: https:\/\/www.paho.org\/es\/temas\/malaria."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1146\/annurev-pathmechdis-012419-032640","article-title":"New Insights into Malaria Pathogenesis","volume":"2415","author":"Moxon","year":"2020","journal-title":"Annu. Rev. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e85140","DOI":"10.7554\/eLife.85140","article-title":"Plasmodium falciparum adapts its investment into replication versus transmission according to the host environment","volume":"12","author":"Abdi","year":"2023","journal-title":"eLife"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.pt.2016.12.012","article-title":"Three Is a Crowd\u2014New Insights into Rosetting in Plasmodium falciparum","volume":"33","author":"Yam","year":"2017","journal-title":"Trends Parasitol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.tmaid.2007.07.002","article-title":"Understanding the role of inflammatory cytokines in malaria and related diseases","volume":"6","author":"Clark","year":"2008","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1186\/s12936-015-1057-9","article-title":"Acute kidney injury in imported Plasmodium falciparum malaria","volume":"14","author":"Koopmans","year":"2015","journal-title":"Malar. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.semnephrol.2008.04.007","article-title":"Malaria and acute kidney injury","volume":"28","author":"Mishra","year":"2008","journal-title":"Semin. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.actatropica.2016.03.031","article-title":"Malarial hepatopathy: Clinical profile and association with other malarial complications","volume":"159","author":"Jain","year":"2016","journal-title":"Acta Trop."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jiph.2013.04.003","article-title":"Clinical profile and complication of malaria hepatopathy","volume":"6","author":"Fazil","year":"2013","journal-title":"J. Infect. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hoffmeister, B. (2023). Respiratory Distress Complicating Falciparum Malaria Imported to Berlin, Germany: Incidence, Burden, and Risk Factors. Microorganisms, 11.","DOI":"10.3390\/microorganisms11061579"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"788","DOI":"10.56050\/01205498.2409","article-title":"Activaci\u00f3n De Muerte Celular En Sepsis Y S\u00edndrome De Dificultad Respiratoria Aguda (SDRA)","volume":"46","year":"2025","journal-title":"Medicina"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"E1081","DOI":"10.1503\/cmaj.171128","article-title":"A 38-year-old man with fever and a history of malaria","volume":"190","author":"Redditt","year":"2018","journal-title":"Can. Med. Assoc. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e00544","DOI":"10.1016\/j.idcr.2019.e00544","article-title":"Severe imported malaria in an intensive care unit: A case series","volume":"17","author":"Chandwani","year":"2019","journal-title":"IDCases"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e926097","DOI":"10.12659\/AJCR.926097","article-title":"A Case of Plasmodium falciparum Malaria Treated with Artesunate in a 55-Year-Old Woman on Return to Florida from a Visit to Ghana","volume":"21","author":"Rodriguez","year":"2020","journal-title":"Am. J. Case Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1239318","DOI":"10.1155\/2023\/1239318","article-title":"Severe Malaria in an Adult Patient from Low-Endemic Area in Flores Island, East Nusa Tenggara","volume":"2023","author":"Teressa","year":"2023","journal-title":"Case Rep. Med."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/8\/1201\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:17:17Z","timestamp":1760033837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/8\/1201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["life15081201"],"URL":"https:\/\/doi.org\/10.3390\/life15081201","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]}}}