Sir,I read an interesting case report of Plasmodiumfalciparum malaria complicated by/disseminated intravascular coagulation, severe normocytic normochromic anemia, and symmetrical peripheral gangrene.[1] With the reemergence of malaria, such rare but unique complications of malaria have been observed from time to time and reported mainly from India.[2345] A few such cases or complications are also reported in Plasmodium vivax[4] and mixed[5] malaria also. Exact pathogenesis could not be ascertained.[2] Microcirculatory block due to sludging of the parasitized erythrocytes in capillaries is a well-known factor in heavy P. falciparum parasitemia. The blockage of terminal arteries/arterioles could be the important reason for the gangrene. The vascular flow in the organs is disturbed by vascular collapse, thrombosis, infarction, and similar effects brought about by clumping together of parasitized cells. All these factors slow down the circulation and cause “sludging.” In a patient presenting with dry gangrene and fever, a possibility of P. falciparum must be kept in mind, not only in endemic areas but, also in nonendemic areas because of the resurgence of P. falciparum in the last few years.[2]