Plasmodium vivax malaria--is it really benign?

It is believed that most of the serious and life threatening complications are caused only by P falciparum infection while P vivax infections are relatively mild and run a benign course and usually not required hospitalisation but in the last few years hospitalisation rate and complications are also increasing in P vivax infection; so we planned this study to evaluate the severity and complicated presentation of P vivax malaria. This hospital-based study conducted in Jawahar Lal Nehru Hospital Ajmer, India. One hundred and two indoor patients with isolated P vivax malaria were included in this study with exclusion of other causes of fever including P falciparum malaria. All patients of severe and complicated P vivax malaria were admitted and treated as severe P falciparum malaria. Severe complications like significant hepatomegaly, thrombocytopenia, acute renal failure, severe anaemia, leucopoenia, electrolyte disturbance, acute respiratory distress syndrome, cerebral malaria, multiorgan dysfunction, hepatic dysfunction, pancytopenia, and death seen in 21.57%, 18.63%, 11.76%, 8.82%, 5.88%, 5.88%, 3.92%, 2.94%, 1.96%, 1.96%, 0.98%, 1.96% patients respectively. A significant proportion of morbidity and mortality in malaria also observed in P vivax infection as seen in P falciparum infection and require hospitalisation.