Malaria (Plasmodium falciparum) - a difficult diagnostic and therapeutic problem

The authors deal with the problem of malaria induced by Plasmodium falciparum and imported to Poland by people returning from tropics. They stress significance of the variable clinical pattern involved and of chloroquine resistance. Basing on their own observations of a definitely diagnosed malaria (22 out 35 cases observed and suspected of malaria) the authors discuss diagnostic and therapeutic difficulties encountered in 7 patients with Plasmodium falciparum-induced malaria. Two representative cases of malaria (Plasmodium falciparum) have been discussed in detail. One of the cases with malaria imported from tropics, presented severe course and an atypical clinical pattern (with involvement of central nervous system) which made appropriate diagnosis difficult and delayed application of specific causal treatment. The other unusual case involved a nurse who contracted Plasmodium through a small skin wound with which patient's blood came into contact when the nurse was drawing blood for testing. Course of the disease was grave, with deep anaemia and central nervous system and kidney involvement. In both cases the disease had favourable outcome due to complex anti-malarial therapy and multispecific medical intervention