In this retrospective study 59 consecutive patients with severe malaria admitted in a Portuguese infectious disease UCI over a 22 year period were considered. Obviously, the longer the period, the greater the impact of lost data, but the sample did not change over time and it includes mostly adult white males, middle-aged, travelling for work reasons. Malaria is a complex disease and it is well known that the higher the parasitaemia the greater the systemic inflammatory response and the production of cytokines and so, a major risk of organ dysfunctions, but some aspects concerning severe forms need to be clarified [21] [22] [23] . The WHO has redefined the criteria of severe malaria and pointed out a list of complications, but prognostic importance of each complication has not been well established. So, parameters usually associated with poor prognosis should not be forgotten and the patients' monitoring according to their presence or possibility, including the admission to an ICU [22] .