[Therapy of severe malaria].
Early diagnosis and differentiation of a probably mild course are the first steps in treatment of severe malaria tropica. After confirming the diagnosis by identification of Plasmodium falciparum in blood smears, causal therapy with quinine should be started immediately, followed by a 2. schizontozidal drug (chloroquine or mefloquine depending on the country of origin). To prevent the typical organ failures adjuvant therapies are as important as the causal therapy with quinine: besides continuous monitoring of vital functions and treatment according to the guidelines of intensive care, packed red cells should be given generously as well as fresh-frozen plasma in complex coagulation disturbances. Prophylactic administration of heparine is of questionable value, corticosteroids should not be given any more in cerebral malaria. Early start with renal replacement therapy (hemodialysis, hemofiltration or peritoneal-dialysis) in oligo-anuric renal failure improves the prognosis in severe malaria. In comatose patients and at signs of multi-organ failure plasma exchange by plasmapheresis and/or whole blood exchange should be performed.
Stuby
U
U
II. Medizinischen Abteilung, a. ö. Krankenhauses Linz.
Biesenbach
G
G
Zazgornik
J
J
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy*; D010961:Plasmodium / Q000187:drug effects; D011379:Prognosis; D014195:Travel
D000962:Antimalarials
Therapie der schweren Malaria.