Malaria related myalgia-arthralgia: an imported case report treated with anti-malarial drug

Abstract

Malaria is still a major health problem in Indonesia, especially in endemic areas. We present an imported case of malaria with prominent subjective complaint of the patient is in the form of persistent muscles and joints pain. A 21 years old female with complaint of intermittent fever and persistent muscle joints paint since one week before seeing a doctor. She had history of repetitive attack of malaria tropica. Physical examination in general showed no clear derangements, but on thick and thin blood smear stained with Giemsa revealed malaria falciparum (+). Combo therapy of antimalarial drug soon be given and the patient healed with the disappearance of all previous complaint. Myalgia and arthralgia in case of malaria falciparum (+) might be the earliest subjective sign of rhabdomyolisis, a potentially fatal and lethal complication of malaria.

Malarial Related Myopathies: A Rhabdomyolysis Story

“…In human, there are already known 5 species of Plasmodium that can caused infection, namely Plasmodium falciparum, P. vivax, P. ovale, P. malariae, and P.knowlesi [1,2]. The disease is still most prevalent in many region globally, especially in Southeast Asia and Sub Saharan Africa [3].…”

“…Myalgia is a subjective and at the same time also objective muscular complaint, and it is not always prominent [1]. In severe form of malaria, although very rare, a condition of myalgia related rhabdomyolysis with myoglobinuria and skeletal muscle necrosis can occur; sometime it precede renal failure secondary to acute tubular necrosis, a very fatal complication of untreated malaria, found on both vivax or falciparum malaria [9][10][11].…”