Fatal falciparum malaria in Canadian travellers.
The authors report 2 cases of severe falciparum malaria in Canadians that had fatal outcomes. In the first case a man presented to a local hospital shortly after returning from Africa, but a diagnosis of malaria was not considered. He was transferred to a secondary and then to a tertiary care facility, where he subsequently died. Intravenous quinidine therapy, the treatment of choice, was unavailable at all 3 hospitals. In the second case, a woman taking chloroquine prophylaxis while visiting Nigeria developed cerebral malaria and died. These cases illustrate critical management issues: appropriate advice on malaria prevention before departure; consideration of malaria in all febrile people returning from an endemic area; ready access to parenteral therapy for severe malaria in Canadian hospitals; and an increase in awareness of travel medicine among family physicians.
Humar
A
A
Department of Medicine, University of Toronto, Ont.
Sharma
S
S
Zoutman
D
D
Kain
K C
KC
D000349:Africa; D000368:Aged; D002170:Canada; D003951:Diagnostic Errors; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000175:diagnosis; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014195:Travel