Acute Kidney Injury and Post-Artesunate Delayed Haemolysis in the Course of Plasmodium falciparum Malaria

Malaria is a major international public health problem. The risk of acquiring malaria varies depending on the intensity of transmission and adherence to mosquito precautions and prophylaxis recommendations. Severe malaria can cause significant multiorgan dysfunction, including acute kidney injury (AKI). Intravenous artesunate is the treatment of choice for severe malaria in non-endemic areas. One of the possible events connected with the lifesaving effects of artemisins is post-artesunate haemolysis (PADH), which may be potentially dangerous and under-recognised. We present a case of a seafarer with severe Plasmodium falciparum malaria complicated with AKI and PADH, with a good response to steroid treatment. This case highlights the need for malaria prophylaxis in business travellers, e.g., seafarers to malara-endemic regions, and close supervision of patients with malaria even after the completion of antimalarial treatment due to the possibility of late complications.