Español
Article Sidebar
Main Article Content
Abstract
Malaria is a potentially fatal disease caused by a parasite of the genus Plasmodium. Argentina is a malaria-free country and millions of cases are diagnosed annually worldwide. Hyperparasitemia is a serious factor with a higher risk of therapeutic failure. We describe a case of severe imported malaria with hyperparasitemia, in which pharmacological treatment, extracorporeal organ support and exchange transfusion were performed together, with rapid reduction of parasitemia and favorable evolution. The aim of this study is to present a clinical case with multidisciplinary treatment using exchange transfusion. There are no strict criteria for the indication of exchange transfusion, being the clinical condition that should prevail, it is not recommended as adjuvant therapy, but it could be an option and especially in cases with hyperparasitemia. This paper describes the experience in a single case, which was shown to be a safe adjuvant therapy.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The magazine does not retain the reproduction rights (copyright) so the authors can republish their works with the sole mention of the original publication source.
References
World Health Organization. Guideline for Malaria. Geneva: World Health Organization; 2021. Treatment of severe falciparum malaria; pp. 95–107.
Ministerio de Salud de la Nación. Guía para el manejo clínico de casos de paludismo en Argentina en contexto de eliminación. Coordinación Nacional de Control de Vectores. Informe Técnico. República Argentina. Julio, 2018.
White NJ, Pongtavornpinyo W, Maude RJ, Saralamba S, Aguas R, Stepniewska K, et al. Hyperparasitaemia and low dosing are an important source of anti-malarial drug resistance. Malar J. 2009; 8:253.
Gilles HM. The malaria parasites. In: Gilles HM, Warrell DA, editors. Bruce-Chwatt's Essential Malariology. London, Boston, Melbourne, Auckland: Edward Arnold; 1993. pp. 12-34.
Chung HS, Peck KR, Kim DW. Two case reports of successful therapeutic erythrocytapheresis as an adjunctive therapy in severe falciparum malaria. Ther Apher Dial. 2010;14:230–233.
Mordmüller B, Kremsner PG. Hyperparasitemia and blood exchange transfusion for treatment of children with falciparum malaria. Clin Infect Dis. 1998; 26:850–2.
Watanaboonyongcharoen P, Park YA, Poisson JL, Brecher ME. Rapid increases in parasitemia following red cell exchange for malaria. J Clin Apher. 2011;26:315–319.
Burchard GD, Kröger J, Knobloch J, Hartmann WJ, Eichenlaub D, Moling O, et al. Exchange blood transfusion in severe falciparum malaria: Retrospective evaluation of 61 patients treated with, compared to 63 patients treated without, exchange transfusion. Trop Med Int Health. 1997;2:733–40.
Habeeb H, Ripper JR, Cohen A, Hinfey PB. A case of imported severe plasmodium falciparum malaria in the emergency department and the current role of exchange transfusion treatment. J Emerg Med. 2013;44:e211–e215.
Kreeftmeijer-Vegter AR, Melo Mde M, de Vries PJ, Koelewijn R, van Hellemond JJ, van Genderen PJ. Manual blood exchange transfusion does not significantly contribute to parasite clearance in artesunate-treated individuals with imported severe Plasmodium falciparum malaria. Malar J. 2013; 12:115.
Barman H. Exchange transfusion in complicated pediatric malaria: a critical appraisal. Indian J Crit Care Med. 2015;19:214–219.
Clark IA, Budd AC, Alleva LM, Cowden WB. Human malarial disease: A consequence of inflammatory cytokine release. Malar J. 2006; 5:85.
Calvo-Cano A, Gomez-Junyent J, Lozano M, Castro P, Cid J, Nicolas JM, et al. The role of red blood cell exchange for severe imported malaria in the artesunate era: a retrospective cohort study in a referral centre. Malar J. 2016; 15:216.
Tan KR, Wiegand RE, Arguin PM. Exchange transfusion for severe malaria: evidence base and literature review. Clin Infect Dis. 2013; 57:923–928.
Riddle MS, Jackson JL, Sanders JW, Blazes DL. Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: a meta-analysis. Clin Infect Dis. 2002;34:1192–1198.