title: [Exchange transfusion and (or) plasmapheresis: effective measures in severe tropical malaria?].
abstract: A 42-year-old man was admitted to hospital with, previously wrongly diagnosed, fulminant falciparum malaria, 14 days after a two-week trip to Kenya. He had a high fever and was jaundiced, with severe anaemia and thrombocytopenia. He was given quinine intravenously and pyrimethamine/sulfadoxine (Fansidar) by mouth. He developed acute renal failure and increasingly severe cerebral symptoms, at times coma. An exchange transfusion and several plasmaphereses were, therefore, performed. The cerebral symptoms quickly abated during the exchange transfusion, but renal function failed to improve. Because of continuing fever, mefloquin (Lariam) and doxy-cycline (Vibramycin) were also administered. After several dialysis periods the patient improved gradually and was discharged after three weeks in generally good condition with normal renal function.
authors.affiliation: Transfusionszentrum, Medizinische Klinik III, Universität München.
authors.forename: M U
authors.initials: MU
authors.lastname: Heim
authors.forename: J
authors.initials: J
authors.lastname: Mezger
authors.forename: C
authors.initials: C
authors.lastname: Scheurlen
authors.forename: L
authors.initials: L
authors.lastname: Twardzik
authors.forename: W
authors.initials: W
authors.lastname: Wilmanns
mesh_terms: D000208:Acute Disease; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005078:Exchange Transfusion, Whole Blood; D006440:Hemofiltration; D006801:Humans; D008288:Malaria / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D010956:Plasmapheresis; D010963:Plasmodium falciparum
chemical_list: D000962:Antimalarials
vernacular_title: Austauschtransfusion und (oder) Plasmapherese: wirksame Massnahmen bei der schweren Malaria tropica?