Successful treatment of imported cerebral malaria with artesunate-mefloquine combination therapy
Journal
Journal of the Formosan Medical Association
Journal Volume
105
Journal Issue
1
Pages
86-89
Date Issued
2006
Author(s)
HSIN-YUN SUN
CHI-TAI FANG
JANN-TAY WANG
PING-HUNG KUO
YEE-CHUN CHEN
SHAN-CHWEN CHANG
Abstract
Treatment of cerebral malaria with intravenous quinine is frequently associated with life-threatening cardiotoxicity. We report a case of imported cerebral malaria successfully treated with artesunate-mefloquine combination therapy. The 27-year-old woman presented with fever, sudden onset of binocular blindness and altered consciousness 10 days after a short stay in Indonesia. Hyperparasitemia with Plasmodium falciparum and P. vivax in more than 5% of red blood cells was demonstrated on peripheral blood smear. She was admitted to the intensive care unit due to shock, jaundice and acute renal failure. Because of a shortage of intravenous quinine, intravenous artesunate was given as an alternative. Her condition stabilized on the 3rd day of therapy, with resolution of fever and disappearance of parasitemia. Consolidation therapy with oral mefloquine and primaquine was then given to prevent recrudescence and relapse. The only adverse event associated with artesunate was transient reticulocytopenia, which resolved after discontinuation of therapy. Her vision completely recovered, along with renal and liver function. ?2006 Elsevier & Formosan Medical Association.
SDGs
Other Subjects
artesunate; aspartate aminotransferase; bilirubin; creatinine; hemoglobin; lactate dehydrogenase; mefloquine; nitrogen; primaquine; quinine; urea; adult; anamnesis; anemia; article; bilirubin blood level; brain malaria; brain scintiscanning; case report; clinical feature; computer assisted tomography; creatinine blood level; cytopenia; drug substitution; encephalitis; eradication therapy; female; hematocrit; hemoglobin determination; human; laboratory test; leukocyte count; nuclear magnetic resonance imaging; parasitemia; reticulosis; thrombocyte count; travel; treatment outcome; treatment withdrawal; urea nitrogen blood level; urinalysis
Publisher
Scientific Communications International Ltd
Type
journal article
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