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Considerations on the use of adjunct red blood cell exchange transfusion in the treatment of severe Plasmodium falciparum malaria
Author(s) -
Shelat Suresh G.,
Lott Jason P.,
Braga Matthew S.
Publication year - 2010
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2009.02530.x
Subject(s) - parasitemia , malaria , plasmodium falciparum , medicine , adjunct , exchange transfusion , quinine , severe malaria , intensive care medicine , immunology , hepatitis , linguistics , philosophy
BACKGROUND: Travelers returning to the United States from malaria‐endemic areas are at increased risk of a potentially fatal infection from Plasmodium falciparum , which requires prompt and aggressive treatment. STUDY DESIGN AND METHODS: Described is a case of a 7‐year‐old boy who was infected by P. falciparum while in Africa and developed features of severe infection, including hyperparasitemia, altered neurologic status, and malarial hepatitis. RESULTS: A single automated erythrocytapheresis procedure reduced parasitemia from 14% to less than 1%. Along with intravenous quinidine, this reduced parasite level was maintained throughout the hospitalization and the patient recovered. CONCLUSION: Exchange transfusion (ET) is an effective adjunct therapy to reduce the parasite load in cases of severe P. falciparum malaria. When performed in certain defined settings, the benefits can outweigh the risks of the procedure. Discussed are the medical and technical considerations on the use of adjunctive ET for severe P. falciparum infection and a review of the literature of the use of adjunct ET in the treatment of severe P. falciparum malaria.