Two Cases of Cerebral Malaria Treated with Therapeutic Erythrocytapheresie.
- Author:
Jae Woo SONG
1
;
Chang Kee KIM
;
Woon Hyoung LEE
;
Hyun Sook LIM
;
Hyun Ok KIM
;
June Myung KIM
Author Information
1. Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
RBC exchange;
Plasmodium falciparum;
Cerebral malaria
- MeSH:
Adult;
Cameroon;
Congo;
Doxycycline;
Drug Therapy;
Emergency Service, Hospital;
Fever;
Headache;
Humans;
Malaria, Cerebral*;
Male;
Middle Aged;
Neurologic Manifestations;
Parasitemia;
Parasites;
Plasmodium falciparum;
Quinidine
- From:Korean Journal of Blood Transfusion
2003;14(2):234-239
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cerebral malalria is a life-threatening complication of Plasmodium falciparum infection. RBC exchange transfusion (RCE) can reduce the burden of parasitemia in this situation. We have experienced two cases of cerebral malaria treated with automated RBC exchange as an adjunct to standard chemotherapy. Case 1: A 42-year-old male was referred to the emergency room with a history of 3 days of fever after having returned from Congo. Peripheral blood smear showed the P. falciparum parasitemia of 70-80%. Quinidine and doxycycline were administered but, mental state started to deteriorate. He underwent RCE on hospital day 2 to reduce the parasitemia to 10% after 8 hours. No parasite could be found on day 3 after the RCE. Case 2: A 62-year-old male was referred to the emergency room with a history of 3 days of fever after having returned from Cameroon. P. falciparum parasitemia was 10% on peripheral blood smear. Quinidine and doxycycline were immediately started but headache developed abruptly and he underwent RCE on hospital day 3. After 8 hours following the completion of RCE, parasitemia decreased to less than 1%. Automated RBC exchange transfusion can rapidly reduce the burden of parasitemia and achieve improvement of neurologic symptom and sign in patients with cerebral malaria.
