What is a major complication of untreated Plasmodium falciparum malaria?

Severe anemia is a major complication of untreated Plasmodium falciparum malaria due to the destruction of red blood cells that the parasite causes. P. falciparum infects and multiplies within red blood cells, leading to their lysis, which can result in a significant decrease in the number of circulating red blood cells. This condition can severely impair the oxygen-carrying capacity of the blood, leading to symptoms such as extreme fatigue, weakness, and in severe cases, respiratory distress or organ failure. Additionally, the resultant anemia can exacerbate the overall condition of the patient, making them more susceptible to other complications, including infections.

In contrast, chronic fatigue syndrome is more associated with a long-term or unresolved health condition rather than a specific consequence of malaria infection. Acute respiratory distress syndrome can occur in severe cases, but it is not the primary complication directly related to the hemolytic effects of P. falciparum. Dehydration can occur due to fever and other factors associated with malaria, but this is generally not the most significant complication arising directly from the parasitic infection itself. Therefore, the primary and most notable complication of untreated P. falciparum malaria is indeed severe anemia.