کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3248373 1589152 2013 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
A Case of Imported Severe Plasmodium falciparum Malaria in the Emergency Department and the Current Role of Exchange Transfusion Treatment
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی طب اورژانس
پیش نمایش صفحه اول مقاله
A Case of Imported Severe Plasmodium falciparum Malaria in the Emergency Department and the Current Role of Exchange Transfusion Treatment
چکیده انگلیسی

BackgroundThe role of exchange transfusion in the management of severe malaria is not well documented in Emergency Medicine literature.ObjectivesThe goal of this article is to review the importance of considering malaria in the differential diagnosis of the febrile returned traveler and to discuss the role of exchange transfusion in the management of severe Plasmodium falciparum malaria.Case ReportA 59-year-old woman presented to the Emergency Department (ED) with severe P. falciparum malaria. Her physical examination was remarkable for scleral icterus, dry mucous membranes, and tachycardia. Her complete blood count revealed a white blood cell count of 6.9 k/uL, with 71% segmented neutrophils, 19% bands, a hemoglobin level of 11.9 g/dL, hematocrit of 37.2%, and a platelet count of 9 k/uL. Hepatorenal impairment was present and malaria parasites with ring form were seen on malaria prep in 18% of red blood cells. The patient was treated with fluids, platelets, quinidine gluconate, doxycycline, and exchange transfusion with significant improvement in the patient's clinical condition.ConclusionsThe high level of parasitemia presenting with acute kidney injury, hyperbilirubinemia, and thrombocytopenia supported the use of exchange transfusion as adjunct therapy. Exchange transfusion was a reasonable consideration in this case and was well tolerated by our patient. Institutions that are equipped with apheresis units should evaluate each case individually in concert with Centers for Disease Control experts and local consultants and weigh the risks and benefits of the use of exchange transfusion as an adjunct in the treatment of severe P. falciparum malaria.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Emergency Medicine - Volume 44, Issue 2, February 2013, Pages e211–e215
نویسندگان
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