Severe malaria presenting to the ED: A collaborative approach utilizing exchange transfusion and artesunate

Am J Emerg Med. 2018 Jun;36(6):1126.e1-1126.e4. doi: 10.1016/j.ajem.2018.03.023. Epub 2018 Mar 14.

Abstract

We describe the case of a previously healthy 33year-old male pilot recently arrived to the United States from Africa. The patient presented to our ED febrile and disoriented, with projectile coffee-ground emesis. He was later found to have severe malaria and cerebral parasitemia. Due to the severity of his illness, the patient received the anti-malarial medication Artesunate as well as several exchange transfusions. Within 48h his parasitic load was reduced from 42% to 0.4%. The following is an account of a collaborative effort that spans the specialties of emergency medicine, infectious disease, and critical care medicine.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antimalarials / administration & dosage*
  • Antimalarials / pharmacology
  • Artesunate / administration & dosage*
  • Artesunate / pharmacology
  • Critical Care*
  • Emergency Medical Services*
  • Exchange Transfusion, Whole Blood
  • Humans
  • Infectious Disease Medicine*
  • Intersectoral Collaboration
  • Malaria, Cerebral / drug therapy*
  • Malaria, Cerebral / parasitology
  • Male
  • Parasitemia / drug therapy*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antimalarials
  • Artesunate