Diagnosis and treatment of malaria in children.
Malaria continues to be a problem for children returning or immigrating to industrialized countries from tropical regions. Proper diagnosis begins with clinical suspicion. In nonimmune children, malaria typically presents with high fever that might be accompanied by chills and headache. Symptoms and signs may be more subtle in partially immune children, and anemia and hepatosplenomegaly may also be present. Children may present with respiratory distress and/or rapidly progressing cerebral malaria that manifests as altered sensorium and, sometimes, seizures. Thick blood smears help to determine when infection is present, but a single smear without parasites is not sufficient to rule out malaria. Thin blood smears aid in identifying the species of parasite. Treatment must include careful supportive care, and intensive care measures should be available for treating children with complicated Plasmodium falciparum malaria. Medical regimens can include mefloquine, atovaquone-proguanil, sulfadoxine-pyrimethamine, quinine or quinidine, clindamycin, doxycycline, chloroquine, and primaquine.
Division of Infectious Disease and International Medicine, Department of Medicine, University of Minnesota, St. Paul, MN, USA.
William
W
Stauffer
Philip R
PR
Fischer
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D053626:Atovaquone; D002648:Child; D002738:Chloroquine / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000188:drug therapy*; D015767:Mefloquine / Q000627:therapeutic use; D009285:Naphthoquinones / Q000627:therapeutic use; D010963:Plasmodium falciparum; D002727:Proguanil / Q000627:therapeutic use; D011739:Pyrimethamine / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use
D000962:Antimalarials; D004338:Drug Combinations; D009285:Naphthoquinones; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone; D011739:Pyrimethamine