Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report
Malaria is a parasitic disease that is starting to be encountered in intensive care units (ICU) worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alv...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2016-03-01
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| Series: | Iranian Journal of Parasitology |
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| Online Access: | https://ijpa.tums.ac.ir/index.php/ijpa/article/view/819 |
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| author | Elif Ayşe ÇİZMECİ Nermin KELEBEK GİRGİN Ilkay CEYLAN Tekin TUNCEL Oktay ALVER Emin Halis AKALIN |
| author_facet | Elif Ayşe ÇİZMECİ Nermin KELEBEK GİRGİN Ilkay CEYLAN Tekin TUNCEL Oktay ALVER Emin Halis AKALIN |
| author_sort | Elif Ayşe ÇİZMECİ |
| collection | DOAJ |
| description | Malaria is a parasitic disease that is starting to be encountered in intensive care units (ICU) worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alveolar oedema. We present the case of a 25-yr old male patient who presented to the Emergency Department of Uludag University in Bursa, Turkey in the winter of 2014 with complaints of fever for three days. His medical history revealed a 14-month stay in Tanzania. Staining of blood smears revealed characteristic gametocytes in accordance with P. falciparum infection. The day after admission, he had an epileptic seizure after which his Glasgow Coma Scale was 6, so he was intubated and transferred to the ICU. A computerized tomography scan revealed findings of cerebral oedema. Intravenous mannitol was administered for 6 days. Intravenous artemisinin was continued for 10 days. Due to refractory fevers, anti-malarial treatment was switched to quinine and doxycycline on the 14th day and on the 16th day the fevers ceased. This case emphasizes that cerebral malaria should be suspected in cases of seizures accompanying malaria, and treatment should be initiated in the ICU. Furthermore, resistance of P. falciparum to artemisinin should be in mind when a response to therapy is lacking. |
| first_indexed | 2024-12-22T22:41:28Z |
| format | Article |
| id | doaj.art-8872fb7691934ea8ac6195bba1525b59 |
| institution | Directory Open Access Journal |
| issn | 1735-7020 2008-238X |
| language | English |
| last_indexed | 2024-12-22T22:41:28Z |
| publishDate | 2016-03-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Parasitology |
| spelling | doaj.art-8872fb7691934ea8ac6195bba1525b592022-12-21T18:10:11ZengTehran University of Medical SciencesIranian Journal of Parasitology1735-70202008-238X2016-03-01111558Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case ReportElif Ayşe ÇİZMECİ0Nermin KELEBEK GİRGİN1Ilkay CEYLAN2Tekin TUNCEL3Oktay ALVER4Emin Halis AKALIN5Department of Anesthesiology and Intensive Care, School of Medicine, Uludag University, Bursa, TurkeyDepartment of Anesthesiology and Intensive Care, School of Medicine, Uludag University, Bursa, TurkeyDepartment of Anesthesiology and Intensive Care, School of Medicine, Uludag University, Bursa, TurkeyDepartment of Infectious Diseases, School of Medicine, Uludag University, Bursa, TurkeyDepartment of Microbiology, School of Medicine, Uludag University, Bursa, TurkeyDepartment of Infectious Diseases, School of Medicine, Uludag University, Bursa, TurkeyMalaria is a parasitic disease that is starting to be encountered in intensive care units (ICU) worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alveolar oedema. We present the case of a 25-yr old male patient who presented to the Emergency Department of Uludag University in Bursa, Turkey in the winter of 2014 with complaints of fever for three days. His medical history revealed a 14-month stay in Tanzania. Staining of blood smears revealed characteristic gametocytes in accordance with P. falciparum infection. The day after admission, he had an epileptic seizure after which his Glasgow Coma Scale was 6, so he was intubated and transferred to the ICU. A computerized tomography scan revealed findings of cerebral oedema. Intravenous mannitol was administered for 6 days. Intravenous artemisinin was continued for 10 days. Due to refractory fevers, anti-malarial treatment was switched to quinine and doxycycline on the 14th day and on the 16th day the fevers ceased. This case emphasizes that cerebral malaria should be suspected in cases of seizures accompanying malaria, and treatment should be initiated in the ICU. Furthermore, resistance of P. falciparum to artemisinin should be in mind when a response to therapy is lacking.https://ijpa.tums.ac.ir/index.php/ijpa/article/view/819ArtemisininCerebral malariaIntensive care unit |
| spellingShingle | Elif Ayşe ÇİZMECİ Nermin KELEBEK GİRGİN Ilkay CEYLAN Tekin TUNCEL Oktay ALVER Emin Halis AKALIN Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report Iranian Journal of Parasitology Artemisinin Cerebral malaria Intensive care unit |
| title | Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report |
| title_full | Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report |
| title_fullStr | Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report |
| title_full_unstemmed | Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report |
| title_short | Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report |
| title_sort | cerebral malaria treated with artemisinin in the intensive care unit a case report |
| topic | Artemisinin Cerebral malaria Intensive care unit |
| url | https://ijpa.tums.ac.ir/index.php/ijpa/article/view/819 |
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