Celebral malaria is the most common complications of plasmodium falciparum with a mortality of 20-50%. Apart from special chemotherapy, some additional therapies were applied. Fever relief: in addition of physical method of hypothermy, ventilation, freezing compress, ... paracetamol is recommended. Antiseizure: intravenous diazepam can be infected slowly with 10mg in adults and 0,15mg/kg in children. Blood replaced perfusion is rather an increase of parasite count than a simple special medication, safely regulating severe anemia in patient with circulation overload is recommended only for very severe subjects, with very high level of parasity in blood
Malaria ; drug therapy ; disease ; Therapeutics ; Malaria, Cerebral

Effects of artesunate in the combination of other antimalarial drugs (primaquine, mefloquine or chloroquine) on activities of some murine plasma enzymes were studied: (1) The combination of artesunate with primaquine induced significantly plasma activities of GOT, GPT, LDH, - HBDH, CK and CK- MB in comparison with artesunate alone; (2) The combination of artesunate with mefloquine also induced significantly plasma activities of GOT, GPT, LDH, -HBDH, CK and CK- MB in comparison with artesunate alone; (3) The companation of artesunate with chloroquine reduced slightly plasma activities of GOT, GPT, LDH, -HBDH, CK and CK-MB. The results obtained in the study suggest that the combination of artesunate with primaquine or mefloquine on murine cellular damage is synergistic, while the combination of artesunate with chloroquine is probably antagonistic
Malaria ; artesunate ; drug therapy ; therapeutics ; Pharmaceutical Preparations

Artelinate and metaartelinat are water-soluble and relatively stable derivatives of artemisinin. we carried out studies on the antimalarial action of them. Experiments were done in vitro in mice infected with P.berghei and in vitro with synchronous cultures of P. falciparum. The results showed: artelinat had good effect on both cloroquin sensitive and cloroquin resistant strain of P. berghei and P. falciparum. This effect is better than artemisinin's. Metaartelinate had the same effect with artelinat on cloroquin sensitive P. berghei, but have effect on resistant strain only during treatment time
Malaria ; artesunate ; Pharmaceutical Preparations ; drug therapy

A 7-day in vivo test system was applied to assess the parasitological response to chloroquine treatment in patients with falciparum malaria in the Central Province and National Capital District of Papua New Guinea. 30 patients were investigated but only 23 took a full course of chloroquine and were completely followed up. Of the 23 patients, 13 (57%) were negative for malaria parasites on day 2, 4 (17%) had significantly reduced parasitaemia by day 2 and cleared parasites by day 7, and 1 (4%) showed a partial response (R2). In 5 (22%) of the patients resistance at the R3 level was observed. The indication from this study is that chloroquine should continue to be the first-line drug for the treatment of uncomplicated falciparum malaria. However, judicious use of chloroquine in uncomplicated falciparum malaria is required to halt the spread of chloroquine-resistant strains of Plasmodium falciparum.
Antimalarials - therapeutic use ; Chloroquine - therapeutic use ; Drug Resistance ; Malaria, Falciparum - drug therapy ; Malaria, Falciparum - parasitology

Antimalarials ; therapeutic use ; Artemisinins ; therapeutic use ; Child ; Drug Therapy, Combination ; Humans ; Malaria, Falciparum ; drug therapy

Malaria infection is not uncommon in Korea these days, but there was no report of malaria infection in the patients who had been transplanted his or her kidney. With the immunosuppression, the atypical findings are frequent and make prompt diagnosis difficult. We report a case of malaria which showed atypical clinical course but treated successfully with conventional anti-malarial drug therapy. A 37 year old male patient were transplanted his kidney in Sep. 1997. He was admitted because of fever, which lasted 40 - 50 min every afternoon for 27 days. Numerous trophozoites were found on his peripheral blood smear, which was diagnosed as vivax malaria. Chloroquine and primaquine were given, and fever subsided next day. The patients has been stayed afebrile thereafter. We reported a case of malaria in the renal transplanted patient with the review of literatures.
Adult ; Chloroquine ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Immunosuppression* ; Kidney Transplantation ; Kidney* ; Korea ; Malaria* ; Malaria, Vivax ; Male ; Plasmodium vivax ; Primaquine ; Trophozoites

Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patients with falciparum malaria. Patients with this complication have generally undergone early amputation of the affected areas. In this report, we describe 3 adult Thai patients presented at the Hospital for Tropical Diseases, Bangkok, with high grade of fever ranged 6-9 days, jaundice, acute renal failure, respiratory failure, alteration of consciousness and shock. Two patients had gangrene developed at the lower extremities on day 1 of hospitalization and 1 patient had gangrene developed on day 3. Blood smears revealed hyperparasitemia with Plasmodium falciparum. These patients were diagnosed as having severe malaria with peripheral gangrene. The resolution of gangrene was successfully achieved by treatment with artesunate and conservative treatment in 2 of 3 cases.
Middle Aged ; Male ; Malaria, Falciparum/*complications/drug therapy ; Humans ; Gangrene/*etiology ; Female ; Antimalarials/therapeutic use ; Adult

With increasing travel to tropical area, the number of patients with imported malaria in this country is increasing. RBC exchange transfusion has proposed as a adjunct therapy for very severe falciparum malaria to reduce the parasite load rapidly. We report a patient with severe Plasmodium falciparum infection with 26% of erythrocyte parasitized, treated with RBC exchange transfusion in addition to conventional chemotherapy. The exchange of 1200 mL of red blood cells was carried out with 7 packed red cells using automatic cell separator. This patients recovered from his disease despite respiratory distress syndrome and acute renal failure. We conclude that RBC exchange is a useful adjunct to conventional chemotherapy and should be considered in patients with severe and complicated falciparum malaria.
Acute Kidney Injury ; Drug Therapy ; Erythrocytes ; Humans ; Malaria ; Parasite Load ; Plasmodium falciparum* ; Plasmodium*

Antimalarials ; therapeutic use ; Disease Eradication ; economics ; Humans ; Malaria ; diagnosis ; drug therapy ; prevention & control

As a unicellular organism, Plasmodium displays a panoply of lipid metabolism pathways that are seldom found together in a unicellular organism. These pathways mostly involve the Plasmodium-encoded enzymatic machinery and meet the requirements of membrane synthesis during the rapid cell growth and division throughout the life cycle. Different lipids have varied synthesis and meta-bolism pathways. For example, the major phospholipids are synthesized via CDP-diacylglycerol-dependent pathway in prokaryotes and de novo pathway in eukaryotes, and fatty acids are synthesized mainly via type Ⅱ fatty acid synthesis pathway. The available studies have demonstrated the impacts of artemisinin and its derivatives, the front-line compounds against malaria, on the lipid metabolism of Plasmodium. Therefore, this article reviewed the known lipid metabolism pathways and the effects of artemisinin and its derivatives on these pathways, aiming to deepen the understanding of lipid synthesis and metabolism in Plasmodium and provide a theoretical basis for the research on the mechanisms and drug resistance of artemisinin and other anti-malarial drugs.
Antimalarials/pharmacology* ; Artemisinins/therapeutic use* ; Humans ; Lipid Metabolism ; Malaria/drug therapy* ; Plasmodium