Depletion of Coagulation Factors in Drug-Resistant Plasmodium Falciparum Malaria

United States soldiers with acute relapsed P. falciparum malaria had accelerated intravascular coagulation which was manifested by thrombocytopenia, a prolonged prothrombin time and partial thromboplastin time, a decrease in multiple coagulation factors, and evidence of decreased plasminogen activation with an accumulation of fibrinogen breakdown products in the blood. These changes may be important in the pathophysiology of malaria and cause the hemorrhage and thrombosis found in many organs of patients dying with falciparum malaria.