Successful management of necrotizing pancreatitis in mixed malaria and review of literature

Abstract

Malaria is one of the very common causes of fever in the Indian subcontinent with significant morbidity and mortality. In endemic areas, malaria infection may manifest with a variety of systemic complications ranging from mild to the life-threatening condition including atypical presentations and sometimes a clinical dilemma. We herein report a case of 35-year-old male laborer with complaints of fever, headache, and altered consciousness whose presentation was as case of clinical meningitis, developed acute hepatitis, kidney injury, and necrotizing pancreatitis. Later on, he diagnosed to have mixed malaria infection and improved well to antimalarial drugs with supportive management. In malaria, acute necrotizing pancreatitis is a rare and potentially fatal complication. We also accomplish a systematic review of literature for reports of acute pancreatitis due to Plasmodium infection. This report highlights the occurrence of several rare complications and systematic review of literature for acute pancreatitis due to malaria.

Keywords: Malaria; Plasmodium falciparum; meningitis; necrotizing pancreatitis; renal failure.

Figure 1

Computed tomography of the head revealed calcified granuloma in the left occipital region

Figure 2

Noncontrast computed tomography of the abdomen showing small hypodensity area in body of pancreas suggestive of necrotizing pancreatitis with bilateral pleural effusion