title: Severe imported malaria in adults: retrospective study of 20 cases.
abstract: Severe imported malaria is an important problem in many countries in which this disease is not endemic. This retrospective study describes the characteristics of 20 adults with severe imported malaria admitted to our intensive care unit from 1991 through 2007. All episodes were caused by Plasmodium falciparum and all patients had returned from sub-Saharan Africa, except for one transfusion recipient. All persons were considered non-immune, and none had taken appropriate chemoprophylaxis. The median time between the initiation of symptoms and the diagnosis was seven days. Five patients died (mortality rate = 25%). A higher frequency of unrousable coma and acidosis and a higher median Apache II score at admission was noted in the persons who died. Mortality by severe malaria remains high despite high quality management, which highlights the importance of chemoprophylaxis and early diagnosis and treatment.
authors.affiliation: Barcelona Centre for International Health Research, CRESIB, CIBERESP, Hospital Clinic, Barcelona, Spain. portana1@gmail.com
authors.forename: Ana
authors.initials: A
authors.lastname: González
authors.forename: Josep M
authors.initials: JM
authors.lastname: Nicolás
authors.forename: Jose
authors.initials: J
authors.lastname: Muñoz
authors.forename: Pedro
authors.initials: P
authors.lastname: Castro
authors.forename: Jordi
authors.initials: J
authors.lastname: Mas
authors.forename: Ma Eugenia
authors.initials: ME
authors.lastname: Valls
authors.forename: Josep R
authors.initials: JR
authors.lastname: Coma
authors.forename: Jesús
authors.initials: J
authors.lastname: Aibar
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gascon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014195:Travel; D055815:Young Adult
chemical_list: D000962:Antimalarials