SCCM Resource Library-FCCS Severe Malaria

Pdf Summary

Severe Malaria is a major global health problem, with 3.2 billion people in 95 countries at risk and 214 million cases globally each year. The disease is transmitted by infected female Anopheles mosquitoes and is responsible for 438,000 annual deaths. It is the most life-threatening illness seen in travelers returning from the tropics. Severe Malaria is usually associated with P falciparum infections and is responsible for the majority of malaria-associated deaths. The clinical manifestations of severe malaria can include febrile illness, sudden recurrent temperature increases, chills, nausea, diaphoresis, tachycardia, and myalgias.<br /><br />Severe malaria can lead to organ failure, hyperparasitemia, cerebral malaria, hypoglycemia, acidosis, acute kidney injury, noncardiogenic pulmonary edema, liver dysfunction, hematologic abnormalities, and blackwater fever. There are various risk populations for severe malaria, including young children, pregnant women, nonimmune individuals, partially immune individuals in high transmission areas, HIV-infected individuals, international travelers in nonendemic areas, and immigrants returning to their native countries.<br /><br />Diagnosis of severe malaria involves clinical history, blood smear, and rapid diagnostic testing. Common laboratory findings include thrombocytopenia, metabolic acidosis, hypoglycemia, severe normocytic anemia, hemolysis, hemoglobinuria, elevated lactate, and acute kidney injury.<br /><br />Management of severe malaria includes early recognition of life-threatening manifestations, prompt treatment with intravenous artesunate, conservative fluid management, and finishing a course of artemisinin-based combination therapy. Indicators of poor prognosis include age under 3 years, severe neurologic dysfunction, end-organ dysfunction, liver dysfunction, hypoglycemia, severe anemia, hyperparasitemia, and lactic acidosis.<br /><br />In conclusion, early recognition and diagnosis of severe malaria is crucial in order to effectively manage and treat the disease. Intravenous artesunate is recommended as the first-line therapy, and conservative fluid administration should be implemented in patients without hypotension or volume depletion.

Asset Subtitle

Crisis Management, Infection, 2017

Keywords

Severe Malaria

global health problem

Anopheles mosquitoes

malaria-associated deaths

clinical manifestations

organ failure

diagnosis of severe malaria

management of severe malaria

intravenous artesunate

conservative fluid management

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