 |
| |
 | | Non-drug Therapy | |
- Maintain normal blood glucose levels in patients with severe malaria.
- Consider exchange transfusion in some cases as an adjunct in the treatment of severe P. falciparum malaria.
|
|
Maintain normal blood glucose levels in patients with severe malaria.  |
- Check serum glucose at presentation and every 4 hours during the course of the disease, as well as with seizures or any acute change in mental status.
- Administer 5% or 10% dextrose infusions as needed to keep serum glucose in the normal range.
| Background | Back to top
|
Consider exchange transfusion in some cases as an adjunct in the treatment of severe P. falciparum malaria. |
- Consider exchange transfusion in patients who meet World Health Organization guidelines for severe malaria:
- Parasitemia >30% in the absence of clinical complications
- Parasitemia >10% in the presence of severe disease, especially:
- Cerebral malaria
- Acute renal failure
- Adult respiratory distress syndrome
- Jaundice
- Severe anemia
- Parasitemia >10% and failure to respond to optimal chemotherapy after 12 to 24 hours
- Parasitemia >10% and poor prognostic factors, such as:
- Elderly patient
- Late-stage parasites in peripheral blood
- Be aware that exchange transfusion:
- May be harmful and is associated with fluid overload, risk of transfusion reactions and related infections, and line sepsis
- Does not remove infected erythrocytes that are sequestered in deep tissue capillary beds, including those in the brain
- Does not reduce the parasitemia to zero
| Background | Back to top
| | | FAQs |
|
| Harry Tagbor, MBChB, DrPH, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Rick M. Fairhurst, MD, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Thomas E. Wellems, MD, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
|
|
|
The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
|
PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
|
|
|
Malaria
