Fulminant Plasmodium falciparum infection treated with exchange blood transfusion.
A 48-year-old physician, who was not undergoing malaria chemoprophylaxis, contracted Plasmodium falciparum while working in eastern Thailand. In the hospital, he had a peak parasitemia of 72% RBCs infected, associated with CNS dysfunction. As an adjunct to chemotherapy, a double-volume whole-blood exchange transfusion was performed on the first hospital day, dropping the parasitemia to less than 1% within 32 hours. The patient's clinical condition improved, with a prompt reversal of CNS, hepatic, and renal complications. These results, combined with those in previously reported cases, suggest that exchange transfusion should be considered more generally as a life-saving procedure in P falciparum infections.
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000209:etiology; D003072:Cognition Disorders / Q000209:etiology; D004912:Erythrocytes / Q000469:parasitology; D005078:Exchange Transfusion, Whole Blood; D006801:Humans; D008288:Malaria / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000302:isolation & purification; D013785:Thailand; D014481:United States / Q000208:ethnology