Malaria is a vector-borne disease that is endemic in 91 countries. South East Asia is the second most affected region in the world, with India carrying the highest burden of the disease. Four species of Plasmodium are known to cause malaria in humans. Plasmodium vivax and Plasmodium falciparum are the most common species found in India, but Plasmodium malariae have also been reported. Severe complications of malaria have been more commonly seen in P. falciparum infections, and those caused by P. vivax have been considered benign. However, the literature has alarming reports of complicated malaria seen in vivax infections in recent times. This article reports three such cases of P. vivax infection with severe manifestations of malaria such as are found in P. falciparum. This recent evidence indicates that it is important to suspect complicated malaria in P. vivax infection and initiate the appropriate treatment as early as possible to avoid morbidity and mortality.

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