We reported a rare case of Plasmodium vivax malaria who showed findings of disseminated intravascular coagulation (DIC).
A 50-year-old Japanese male was sent to our hospital with the diagnosis of Plamsodium vivax malaria on the 26th of April, 1990. He had stayed in the Solomon Islands from Oct. 1987 to Dec. 1989, and had febrile episodes during his stay in the island. On April 18, 1990, he complained of a high fever with chills, and showed the same episodes on the 20th, 22th and was diagnosised as malaria. He was treated successfully with the sulfadoxine 500 mg and pyrimethamine 25 mg (Fansidar^®), following the normal temperature on 4th day and disapperance of malarial parasites in the peripheral blood smear on the 6th day.
Interestingly, he had thrombocytopenia and a high titer serum level of fibrin degradation product (FDP) supporting the questionable diagnosis of DIC. Even on the 12th day after improved thrombocytopenia by treatment with Gabexate (FOY) ^®, the serum level of FDP, D-dimer and thrombin-nati-thrombin (TAT) III complex still remained at high titer levels. One month later he was readmitted for a relapse of Plasmodium vivax malaria, when he showed thrombocytopenia but the serum level of FDP, D-dimer, TAT III complex and PM·_α2 PI complex were normal levels. We concluded that the thrombocytopenia and the high titer of FDP at his first admission was a manifestation of DIC.