[Severe falciparum malaria treated with exchange transfusion].
BACKGROUND
Acute severe malaria can be seen at any Norwegian hospital. The prognosis of this serious disease depends on rapid and effective treatment.


METHODS
Two case reports of patients treated with exchange transfusions are presented.


RESULTS
Two young Norwegian women travelled without adequate prophylaxis against malaria in South-East Asia and Central and Southern Africa respectively. A few days after leaving the endemic areas they got high fever, joint and muscular pain, and headache. In one of the patients the symptoms were interpreted as flu symptoms; one week later the patient was admitted to hospital suffering from severe malaria. The other patient was admitted to hospital on the day she returned to Norway, six days after getting febrile. Thin blood films showed Plasmodium falciparum, with 30% and 40-50% parasitaemia respectively. Both patients were icteric with thrombocytopenia and increased creatinine. The first patient had severe renal failure and signs of cerebral affection. She was treated with haemodialysis and exchange transfusions. The other patient was treated with exchange transfusions because of her high parasitaemia. Both patients made a complete recovery and were discharged after three and two weeks.


CONCLUSIONS
Severe falciparum malaria is a condition with high case-fatality if diagnostics and treatment is not optimal. In especially severe cases, exchange transfusion may be lifesaving.
Mørch
Kristine
K
Indremedisinsk avdeling Aust-Agder sykehus 4809 Arendal.
Feruglio
Siri L
SL
Ormaasen
Vidar
V
Bruun
Johan N
JN
D000328:Adult; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000628:therapy*; D020127:Recovery of Function; D014195:Travel