Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Case Report
Abstract
Introduction: Malaria is a severe mosquito-borne illness that can be life-threatening. This infection continues to be a significant global health concern, most prominent in tropical and subtropical regions. Malaria's clinical manifestations exhibit a striking diversity, influenced by geographical variables, the individual's immunity, and age. Diagnosing and treating malaria early is crucial to preventing severe complications and fatalities. This heterogeneity poses unique challenges to its diagnosis and treatment, making it a subject of continuous study and innovation. In this case, we present a case of a patient traveling from an endemic area to a non-endemic area. In this comprehensive examination of malaria, we delve into its intricate tapestry, exploring the wide-ranging symptoms, from uncomplicated to severe forms. This deep dive into the clinical landscape aims to enhance our understanding of this relentless disease, facilitating improved diagnostic techniques and treatment strategies. As we embark on this journey, it becomes clear that tackling malaria demands a multi-faceted approach, integrating epidemiological insights, clinical expertise, and innovative research to combat this enduring global health threat.
Case Presentation: A 33-year-old lady with no known past medical history, under border patrol custody, who originally came from Venezuela to the US-border was presented to the emergency department complaining of fever and dysuria. She started with dysuria and urgency 2 weeks ago while she was in the jungle and was on her usual period using pads, and she needed to cross some rivers and stay for long hours with the same pads. Symptoms were associated with vaginal discharge and white/green cottage cheese-like and intense pruritus. Symptoms continued worsening, and 6 days ago she started presenting with regular episodes of fever quantified at 102, chills, headache, decreased appetite, and 1 episode of non-bloody emesis, for which she was started on Macrobid for 2 days with no improvement. She denies flu symptoms, congestion, sore throat, eye pain, cough, sputum production, hemoptysis, dyspnea, palpitations, bleeding from any source, and no new sexual partners. Upon admission, vital signs revealed a BP of 71/46 mmHg, a RR of 23, a pulse of 105 BPM, and a temperature of 99.7°F. Laboratory results showed Hg 11.6, hematocrit 34%, platelets 51, WBC 7.9, Na 133, K 3.1, creatinine 1.1, AST 42, ALT 67, albumin 3, total bilirubin 1.5, lipase 20, Peripheral blood smear positive for malaria-type organisms. UA showing pyuria. A CT of the abdomen revealed no significant abnormalities. She was admitted for sepsis in the setting of a malaria infection, most likely P. vivax. She met Systemic Inflammatory Response Syndrome (SIRS) criteria with 3 of 4 indicators. Mild transaminitis with a hepatocellular pattern and mild anemia were also noted. Fungal vaginitis and suspected uncomplicated urinary track infection not responding to antibiotic therapy In the ED, she received a bolus of LR 1900 mL, doxycycline, ceftriaxone, acetaminophen, and potassium replacement. Infectious disease was consulted and the patient was managed with Atovaquone and Proguanil
Discussion: Given the patient's history of travel from a malaria-endemic region and characteristic clinical and laboratory findings of malaria diagnosis, particularly P. vivax, this is highly probable. The patient was managed with combination therapy focusing on P. vivax infection, which aligns with the prevalence of chloroquine-resistant malaria in central and southern America. Monitoring and further treatment will be essential to managing this potentially life-threatening condition. Migration is an important global issue, as poorly managed migration can result in various problems, including increased transmission of diseases such as malaria, and may be largely affected by population movements. 1. It is crucial to consider the potential for localized outbreaks of malaria when infected individuals, such as new immigrants, travel from endemic areas to non-endemic regions. This is due to the possibility of inadvertently introducing the malaria parasite to the local mosquito population, which can then infect the non-immune population. The case emphasizes the importance of recognizing imported malaria cases. It underscores the need for early diagnosis and appropriate treatment, especially in individuals with a history of travel through malaria-endemic areas.
Academic/Professional Position
Resident
Mentor/PI Department
Internal Medicine
Recommended Citation
Gonzalez Morales, Elimar; Cho, Eunbee; Gomez Casanovas, Jose; and Haj-Yahya, Khairiya, "Jungle Fever: Navigating Malaria in Immigrant Travelers Patient at South Texas: A Case Report" (2024). Research Symposium. 42.
https://scholarworks.utrgv.edu/somrs/2024/posters/42
Included in
Jungle Fever: Navigating Malaria in Immigrant Travelers Patient at South Texas: A Case Report
Introduction: Malaria is a severe mosquito-borne illness that can be life-threatening. This infection continues to be a significant global health concern, most prominent in tropical and subtropical regions. Malaria's clinical manifestations exhibit a striking diversity, influenced by geographical variables, the individual's immunity, and age. Diagnosing and treating malaria early is crucial to preventing severe complications and fatalities. This heterogeneity poses unique challenges to its diagnosis and treatment, making it a subject of continuous study and innovation. In this case, we present a case of a patient traveling from an endemic area to a non-endemic area. In this comprehensive examination of malaria, we delve into its intricate tapestry, exploring the wide-ranging symptoms, from uncomplicated to severe forms. This deep dive into the clinical landscape aims to enhance our understanding of this relentless disease, facilitating improved diagnostic techniques and treatment strategies. As we embark on this journey, it becomes clear that tackling malaria demands a multi-faceted approach, integrating epidemiological insights, clinical expertise, and innovative research to combat this enduring global health threat.
Case Presentation: A 33-year-old lady with no known past medical history, under border patrol custody, who originally came from Venezuela to the US-border was presented to the emergency department complaining of fever and dysuria. She started with dysuria and urgency 2 weeks ago while she was in the jungle and was on her usual period using pads, and she needed to cross some rivers and stay for long hours with the same pads. Symptoms were associated with vaginal discharge and white/green cottage cheese-like and intense pruritus. Symptoms continued worsening, and 6 days ago she started presenting with regular episodes of fever quantified at 102, chills, headache, decreased appetite, and 1 episode of non-bloody emesis, for which she was started on Macrobid for 2 days with no improvement. She denies flu symptoms, congestion, sore throat, eye pain, cough, sputum production, hemoptysis, dyspnea, palpitations, bleeding from any source, and no new sexual partners. Upon admission, vital signs revealed a BP of 71/46 mmHg, a RR of 23, a pulse of 105 BPM, and a temperature of 99.7°F. Laboratory results showed Hg 11.6, hematocrit 34%, platelets 51, WBC 7.9, Na 133, K 3.1, creatinine 1.1, AST 42, ALT 67, albumin 3, total bilirubin 1.5, lipase 20, Peripheral blood smear positive for malaria-type organisms. UA showing pyuria. A CT of the abdomen revealed no significant abnormalities. She was admitted for sepsis in the setting of a malaria infection, most likely P. vivax. She met Systemic Inflammatory Response Syndrome (SIRS) criteria with 3 of 4 indicators. Mild transaminitis with a hepatocellular pattern and mild anemia were also noted. Fungal vaginitis and suspected uncomplicated urinary track infection not responding to antibiotic therapy In the ED, she received a bolus of LR 1900 mL, doxycycline, ceftriaxone, acetaminophen, and potassium replacement. Infectious disease was consulted and the patient was managed with Atovaquone and Proguanil
Discussion: Given the patient's history of travel from a malaria-endemic region and characteristic clinical and laboratory findings of malaria diagnosis, particularly P. vivax, this is highly probable. The patient was managed with combination therapy focusing on P. vivax infection, which aligns with the prevalence of chloroquine-resistant malaria in central and southern America. Monitoring and further treatment will be essential to managing this potentially life-threatening condition. Migration is an important global issue, as poorly managed migration can result in various problems, including increased transmission of diseases such as malaria, and may be largely affected by population movements. 1. It is crucial to consider the potential for localized outbreaks of malaria when infected individuals, such as new immigrants, travel from endemic areas to non-endemic regions. This is due to the possibility of inadvertently introducing the malaria parasite to the local mosquito population, which can then infect the non-immune population. The case emphasizes the importance of recognizing imported malaria cases. It underscores the need for early diagnosis and appropriate treatment, especially in individuals with a history of travel through malaria-endemic areas.