Plasmodium vivax malarial species are associated with ARDS is life-threatening condition rarely occurs in teenagers. ARDS may occur either at the initiation of treatment or after the decline of parasitemia when the patient is improving. We have reported a 17-year-old teenager patient presented to ER with high-grade fever, chills and generalized body ache for 3 days diagnosed with malaria due to P. vivax and developed ARDS during hospitalization. Chest X-ray reported dense heterogeneous opacities in bilateral lungs fields with sparing of apices and ABGs exhibited type 1 respiratory failure. The patient was shifted to ICU and put on BiPAP for non-invasive ventilation. An ICT was positive for P. vivax malaria thus empiric treatment was started with IV Artesunate, followed by a combination of IV Piperacillin Tazobactam along with supportive treatment for ARDS. Patient was discharged on day 8 in better clinical condition and was prescribed Primaquine to prevent any recurrence. P. vivax-associated ARDS has a high mortality rate. Early diagnosis and timely therapeutic treatment along with ventilation support can be life-saving.

Index Terms- ARDS, Artesunate, Non-invasive ventilation, Plasmodium vivax, Primaquine, Teenager