Hemolysis is most severe with Plasmodium falciparum infection compared to the malarial parasites because of-

falciparum infection This is the most dangerous of the malarias. The onset is often insidious, with malaise, headache and vomiting. Cough and mild diarrhoea are also common. The fever has no paicular pattern. Jaundice is common due to haemolysis and hepatic dysfunction. The liver and spleen enlarge and may become tender. Anaemia develops rapidly, as does thrombocytopenia. A patient with falciparum malaria, apparently not seriously ill, may rapidly develop dangerous complications . Cerebral malaria is manifested by delirium, seizures or coma, usually without localising signs. Children die rapidly without any specific symptoms other than fever. Immunity is impaired in pregnancy and the parasite can preferentially bind to the placental protein chondroitin sulphate A. Aboion and intrauterine growth retardation from parasitisation of the maternal side of the placenta are frequent. Previous splenectomy increases the risk of severe malaria.and has high risk of haemolysis is seen . Ref Harrison20th edition pg 1077