Death due to vivax malaria is very rare. Most malaria related fatalities occur due to P. falciparum malaria that can kill a non immune person within a week or two of infection.

Red Blood Cells which are invaded by the P.falciparum become very sticky and attach themselves to the walls of the capillaries. This blocks the microcirculation and thus causes cellular hypoxia, hypoglycemia, lacticacidosis and increased cellular permeability. These changes result in cerebral, pulmonary and renal manifestations.

Complications of Falciparum Malaria.
1. Cerebral Malaria - should be suspected in cases with history of short fever followed by deep unconsciousness in endemic areas. This accounts for 80% of deaths from acute malaria.
2. Algid Malaria - characterised by vomiting, nausea, diarrhoea, dehydration, low blood pressure, rapid respiration and low urine output.
3. Blackwater Fever - is caused by sudden extensive destruction of RBCs in the blood. Haemoglobin is found in the urine and this condition may precipitate renal failure. At times this condition is precipitated by the administration of Quinine to the patient.
4. Pernicious Anaemia - when blood contains a very high number of malaria parasite leading to rapid destruction of the RBCs.
5. Pulmonary Oedema and Adult Respiratory distress syndrome.
6. Vascular Collapse and Shock with Hypothermia and Adrenal Insufficiency.
7. Febrile Convulsions.
8. Hyperpyrexia
9. Metabolic Acidosis