Exchange transfusion in children with severe falciparum malaria and heavy parasitaemia.
While exchange transfusion has been advocated as an adjunctive treatment in severe falciparum malaria complicated by heavy parasitaemia, its role in severe life-threatening disease refractory to standard life support measures is less well recognised. We describe four children with severe falciparum malaria, multi-system involvement and heavy parasitaemia in whom we undertook exchange transfusion because of their deteriorating clinical condition despite antimalarials and supportive therapy. All patients received quinine (one also received artesunate). All patients improved dramatically following the procedure, with subsequent complete clinical recovery.
Shanbag
Preeti
P
Paediatric Intensive Care Unit, Department of Paediatrics, Lokmanya Tilak Municipal Medical College & General Hospital, Mumbai, India. pshanbag@yahoo.com
Juvekar
Manisha
M
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Vaishali
V
Vaidya
Mamta
M
D000962:Antimalarials / Q000627:therapeutic use; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000628:therapy*; D008297:Male; D018512:Parasitemia / Q000628:therapy*; D011803:Quinine / Q000627:therapeutic use
D000962:Antimalarials; D011803:Quinine