Among the different species of
Plasmodium,
Plasmodium falciparum and
Plasmodium vivax account for majority of malaria infection worldwide. Complicated malaria is observed to be a consequence of
P. falciparum infection mainly [
1]. In contrast,
P. vivax is found to be relatively benign. However, many recent reports from Africa, Southeast Asia and India highlighted its association in causation of complicated malaria [
2‐
5]. The complications in vivax malaria were observed in the form of severe anaemia, thrombocytopaenia, pulmonary oedema, renal failure, metabolic imbalance, and cerebral malaria, etc. Thrombocytopaenia is found to be more commonly associated with vivax in comparison to falciparum malaria [
6]. It is associated with the activation of coagulation pathway followed by disseminated intravascular coagulation (DIC) in severe falciparum malaria [
7,
8]. But, apart from few case reports, there is no strong evidence to prove the above hypothesis in
P. vivax infection. DIC is diagnosed as a combination of clinical features such as haemorrhagic manifestations and laboratory tests (i e, prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimers, fibrinogen degradation product, etc.). However, absence of bleeding is often considered as negative for DIC and misdiagnosed many non-overt (early) cases of DIC. Apart from routine laboratory tests, thromboelastograpy (TEG) is a popular method for early and accurate detection of DIC in trauma, organ transplant, cardiac surgery, and obstetric procedures [
9]. TEG measures the changes in the coagulation in vitro, i e, from the initial clotting cascade, platelet interaction, clot strength and lastly the fibrinolysis. Hence, it can correctly predict the early onset of DIC before the patient manifests and guide the therapy. In the present study, was aimed to detect early onset of DIC in vivax malaria cases by TEG. It was also tried to find out the correlation of development of DIC with the severity of the disease.