Korean J Blood Transfus.  2003 Dec;14(2):234-239.

Two Cases of Cerebral Malaria Treated with Therapeutic Erythrocytapheresie

• Song JW
• Kim CK
• Lee WH
• Lim HS
• Kim HO
• Kim JM

Abstract

Cerebral malalria is a life-threatening complication of Plasmodium falciparum infection. RBC exchange transfusion (RCE) can reduce the burden of parasitemia in this situation. We have experienced two cases of cerebral malaria treated with automated RBC exchange as an adjunct to standard chemotherapy. Case 1: A 42-year-old male was referred to the emergency room with a history of 3 days of fever after having returned from Congo. Peripheral blood smear showed the P. falciparum parasitemia of 70-80%. Quinidine and doxycycline were administered but, mental state started to deteriorate. He underwent RCE on hospital day 2 to reduce the parasitemia to 10% after 8 hours. No parasite could be found on day 3 after the RCE. Case 2: A 62-year-old male was referred to the emergency room with a history of 3 days of fever after having returned from Cameroon. P. falciparum parasitemia was 10% on peripheral blood smear. Quinidine and doxycycline were immediately started but headache developed abruptly and he underwent RCE on hospital day 3. After 8 hours following the completion of RCE, parasitemia decreased to less than 1%. Automated RBC exchange transfusion can rapidly reduce the burden of parasitemia and achieve improvement of neurologic symptom and sign in patients with cerebral malaria.

Keyword

RBC exchange; Plasmodium falciparum; Cerebral malaria

MeSH Terms

Adult
Cameroon
Congo
Doxycycline
Drug Therapy
Emergency Service, Hospital
Fever
Headache
Humans
Malaria, Cerebral*
Male
Middle Aged
Neurologic Manifestations
Parasitemia
Parasites
Plasmodium falciparum
Quinidine
Doxycycline
Quinidine