Malaria and the lung

Lung pathology is an important feature of severe and complicated malaria caused by Plasmodium falciparum. The principal and most severe pulmonary manifestation is pulmonary edema. This manifestation is more frequent in adults than children and shares many characteristics of acute lung injury/acute respiratory distress syndrome of diverse causes. The cellular mechanisms underlying the pathophysiology of P. falciparum malaria and pulmonary edema in particular are complex and incompletely understood. Severe malaria in childhood with metabolic acidosis has overlapping clinical features with pneumonia, which poses diagnostic and therapeutic difficulties where diagnostic facilities are limited. This article, which focuses primarily on adults, examines the clinical features of malaria, malaria-induced lung disease, pathology, pathophysiology, and treatment.