15-Year-Old Girl Recovers from Severe Falciparum Malaria and Multi-Organ Failure at Rainbow Children’s Hospital, Rajahmundry

Presented in shock with no urine output for 48 hours; required 72 hours of CRRT and eight dialysis sessions before recovering kidney function

Rajahmundry, 09^th September, 2026: What began as six days of fever, vomiting and abdominal pain rapidly progressed into a life-threatening illness for 15-year-old Ms. J. Greeshma, who was referred to Rainbow Children’s Hospital, Rajahmundry, with severe falciparum malaria and multi-organ failure. She arrived in shock, had not passed urine for nearly 48 hours, and had significant kidney and liver dysfunction, anemia and thrombocytopenia. Her condition was subsequently complicated by acute pancreatitis.

On arrival, she was in severe hypotensive shock with a blood pressure of 70/45 mmHg, along with anuria, poor peripheral perfusion and severe metabolic acidosis. Investigations confirmed Plasmodium falciparum malaria with significant kidney and liver dysfunction, anemia, thrombocytopenia and elevated lactate levels. She was immediately shifted to the Pediatric Intensive Care Unit, where she received circulatory support, mechanical ventilation for neuroprotection and prompt intravenous artesunate therapy.

With persistent anuria and worsening renal failure, she required Continuous Renal Replacement Therapy (CRRT) for 72 hours, followed by intermittent hemodialysis. In total, she underwent eight dialysis sessions before her kidney function began to recover. Her course was further complicated by severe hypertension and acute pancreatitis, which were managed medically.

Following intensive multidisciplinary care, her urine output gradually returned and organ function improved. Metabolic abnormalities resolved, platelet counts normalized and liver function showed significant improvement. At discharge, she was afebrile, hemodynamically stable and tolerating oral feeds, with her serum creatinine reduced to 0.9 mg/dL and blood urea to 21 mg/dL, indicating recovery of kidney function.

Dr. Hema Kumar Nagappagari, Consultant Pediatric Intensivist & Pediatrician, DCH, DNB, Fellowship in Pediatric Care Medicine, said: “By the time this child reached us, the infection had already led to severe complications, including shock and complete renal shutdown. Stabilizing her circulation, treating the infection promptly and supporting the failing organs were critical during the initial phase. The fact that her kidney function eventually returned to normal after prolonged renal support was a significant part of her recovery.”

Dr. Chedulla Pruthvi Ranganath, General Pediatrician & Pediatric Intensivist, MBBS, DNB Pediatrics, Fellowship in Pediatric Intensive Care, said, “Severe falciparum malaria can deteriorate rapidly and affect several organs at the same time. In this case, the child required intensive management for shock, renal failure, liver dysfunction and pancreatitis. Early recognition, timely referral and access to pediatric intensive care and renal replacement therapy were important in helping her recover from a critical stage of illness.”

The treating team emphasized that severe falciparum malaria requires urgent treatment and close monitoring, as the infection can progress rapidly to life-threatening complications. The successful outcome in this case was supported by coordinated care from the Pediatric Intensive Care, Pediatric Nephrology, Pediatric Infectious Diseases and multidisciplinary critical care teams at Rainbow Children’s Hospital, Rajahmundry.

About Rainbow Children’s Medicare Limited 

Rainbow Children’s Medicare Limited network comprises of 26 hospitals and 7 clinics in 9 cities with a total bed capacity of ~ 2,700 beds. Our Pediatric services operating under the brand “Rainbow Children’s Hospital” includes newborn and pediatric intensive care, pediatric multi-specialty services, pediatric quaternary care (including organ transplantation); whereas our women care services under “Birthright by Rainbow” offers perinatal care services which includes normal and complex obstetric care, multi-disciplinary fetal care, perinatal genetic and fertility care along with gynecology services. 

Rainbow Children’s Hospital built on strong fundamentals of a multidisciplinary approach with a full-time consultant led clinical service along with 24/7 commitment in a child centric environment. The company follows a hub-and-spoke operating model where the hub hospital provides comprehensive outpatient, inpatient care, with a focus on tertiary and quaternary services, while the spokes provide 24/7 emergency care, large outpatient services and comprehensive obstetrics, pediatric inpatient and level 3 NICU services. This model is successfully operational at Hyderabad and Bengaluru. The endeavor is to replicate this approach in Chennai and across the National Capital Region. Subsequently Rainbow intends to expand into tier-2 cities of Southern India. 

Rainbow Children’s Hospital embraces a unique doctor engagement model, where doctors work exclusively on a full-time, retainer basis. The doctors work in teams and have 24/7 commitment, which is particularly important for children’s emergency, neonatal, pediatric intensive care services and to support pediatric retrieval services. The Company also operates the country’s largest pediatric DNB training programme in private healthcare, offering post graduate residential DNB and fellowship programme. 1 including the 130 beds at Malviya Nagar where Rainbow Hospitals provides Medical services .