title: Severe imported malaria: clinical presentation at the time of hospital admission and outcome in 42 cases diagnosed from 1996 to 2002.
abstract: The objectives of this retrospective study were to describe initial clinical profiles and subsequent outcome of adult patients in France who were diagnosed with severe imported malaria, as defined by the World Health Organization (WHO). Forty-two patients diagnosed from 1996 to 2002 were included (median age: 30 years, men: 78%, non-immune persons: 74%, return from Africa: 100%, inappropriate antimalarial chemoprophylaxis: 95%). At the time of hospital admission, jaundice (62%), hyperparasitemia (56%), and prostration (52%) were the most frequent findings, followed by acute renal failure (31%). Other findings, as described by the WHO criteria, were less common. Twenty-three patients presented only with jaundice, hyperparasitemia, or prostration in isolation, or in combination. Of these 23, five non-immune persons subsequently developed coma, shock, acute respiratory distress syndrome or acute renal failure; this led to death in 2 of these cases. This suggests that non-immune persons with imported malaria who present with jaundice, hyperparasitemia, or prostration should be admitted to the intensive care unit for close monitoring.
authors.affiliation: Service d'Accueil des Urgences, Hôpital Nord, Marseille, France.
authors.forename: Sékéné
authors.initials: S
authors.lastname: Badiaga
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Carpentier
authors.forename: Philippe
authors.initials: P
authors.lastname: Hovette
authors.forename: Fabien
authors.initials: F
authors.lastname: Duigou
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Manelli
authors.forename: Claude
authors.initials: C
authors.lastname: Martin
authors.forename: Jean
authors.initials: J
authors.lastname: Delmont
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D005602:France; D006306:Health Surveys; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010963:Plasmodium falciparum; D011803:Quinine / Q000627:therapeutic use; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014195:Travel; D016896:Treatment Outcome; D014944:World Health Organization
chemical_list: D011803:Quinine