17 July 2026
: Case report 
Two Cases of Malaria-Associated Acute Respiratory Distress Syndrome and Severe Pulmonary Complications From Plasmodium falciparum in Tanzania
Unusual clinical course, Challenging differential diagnosis, Management of emergency care, Educational Purpose (only if useful for a systematic review or synthesis)
Hilary Chipongo EF 1*, Samina Chaki
AB 2, Esmail Sangey CD 1, Ronald Mclarty F 2, Rawya S.A. Baabde BEF 1, Kaushik Ramaiya ACE 3
DOI: 10.12659/AJCR.951737
Am J Case Rep 2026; 27:e951737
Table 1 Laboratory investigations in case 1 from admission to discharge.
| Test | Admission | ICU Day 2 | ICU Day 4 | ICU Day 6 |
|---|---|---|---|---|
| Hemoglobin (11–13.5 g/dL) | 7.7 | 9.2 | 11.2 | 15.6 |
| Malaria B/S (parasites/200 WBC) | 684/200 WBC | 450/200 WBC | 36/200 WBC | 0/200 WBC |
| Creatinine (60–120 μmol/L) | 124 | 96 | 47 | 67 |
| Urea (2.5–7.8 mmol/L) | 18 | 11 | 3.1 | 8 |
| Bilirubin, total (3.4–20.5 μmol/L) | 459 | 450 | 196 | 116 |
| Bilirubin, direct (0–5.1 μmol/L) | 380 | 371 | 171 | 102 |
| AST (10–40 U/L) | 2489 | 1330 | 667 | 220 |
| ALT (7–56 U/L) | 914 | 591 | 406 | 190 |
| Albumin (35–54 g/L) | 24.3 | 25.2 | 30 | 33 |
| C-reactive protein (<1 mg/dL) | 164 | 105 | 58 | 43 |
| Procalcitonin (<0.1 ng/mL) | 23 | 17 | 9 | 5 |
| Hepatitis B | Non-reactive | – | – | – |
| Hepatitis C | Non-reactive | – | – | – |
| HIV | Negative | – | – | – |
| Calcium (2.1–2.6 mmol/L) | 1.62 | 1.85 | 1.97 | 2.87 |
| Magnesium (0.7–1.05 mmol/L) | 0.98 | 1.13 | 2.1 | 3.35 |
| Sodium (135–145 mmol/L) | 127 | 130 | 132 | 130 |
| Potassium (3.5–5.5 mmol/L) | 5.18 | 4.8 | 3.1 | 3.3 |
| Chloride (96–106 mmol/L) | 104 | 100 | 98 | 97 |
| Abbreviations: B/S, blood smear; ALT, alanine aminotransferase; AST, aspartate aminotransferase. | ||||