A Case of Severe Falciparum Malaria Successfully Treated with Rectal Artesunate and Intravenous Quinine in Combination

AMANO Yuichiro, MIYATA Nobuyuki, SUZUKI Takumitsu, YOSHIMURA Yukihiro, TACHIKAWA Natsuo

doi:10.11150/kansenshogakuzasshi.92.690

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高原虫血症（寄生率42.7％）の重症マラリアに対し，キニーネ注射薬およびアーテスネート坐薬の併用療法で救命しえた1 例
症例高原虫血症(寄生率42.7%)の重症マラリアに対し,キニーネ注射薬およびアーテスネート坐薬の併用療法で救命しえた1例
ショウレイコウゲンチュウケッショウ(キセイリツ 42.7%)ノジュウショウマラリアニタイシ,キニーネチュウシャヤクオヨビアーテスネートザヤクノヘイヨウリョウホウデキュウメイシエタ 1レイ

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<p>We report herein on a 61-year-old Japanese man with severe falciparum malaria after visiting African countries. He presented with shock, impaired consciousness, acidosis, renal impairment, jaundice, pulmonary edema and hyperparasitemia (42.7%). We admitted him to our intensive-care unit. He was initially treated with intravenous quinine (4,500mg for 3 days), rectal artesunate (1,200mg for 5days) and aggressive supportive therapy. The sequential treatment was mefloquine on day 7 (1,925mg). The 99% parasite clearance time and ICU stay were 92 hours and 8days, respectively. He was discharged without complications on the 28th day. Severe malaria, especially cerebral malaria, is a highly mortal disease requiring urgent treatment. Intravenous artesunate is now recommended as the treatment of choice for severe malaria by the World Health Organization, but it is unavilable in Japan. We found that our combination treatment had excellent antimalarial activity with rapid efficacy, and was safe and well-tolerated.</p>

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Kansenshogaku Zasshi

Kansenshogaku Zasshi 92 (5), 690-695, 2018-09-20

The Japanese Association for Infectious Diseases

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