Hyperglycemia and ketoacidosis in severe malaria: A case report

Malaria is a major cause of morbidity and mortality worldwide, primarily in Africa and South East Asia. Here we report a case of severe Plasmodium falciparum malaria with an unusual presentation. The patient was a 29-year-old man with severe malaria who presented with hyperglycemia and ketoacidosis but had no documented history of diabetes mellitus. Treatment was initiated, but his condition deteriorated. Eventually, he experienced cardiac arrest and died. In most cases of malaria, patients show signs of hypoglycemia, which can be caused by either an increase in glucose consumption by the parasite or administration of quinine that causes hyperinsulinemia. Cases of severe malaria with hyperglycemia and ketoacidosis have rarely been reported, and this may result in lack of anticipation of possible complication and mortality. Physicians should not delay treatment in cases of severe malaria with an unusual presentation.