Diagnosis and Management of Severe Malaria

a review

The lecture duration is 24min.

0.5 CPD Points, 0.5 CEUs, 0.5 CME credits approval pending.
Accredited by CPDUK, CBRN and Provider Pending.

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Arjen Dondorp
Professor of Tropical Medicine at the University of Oxford, UK
Lecture Summary

The vast majority of severe malaria is caused by Plasmodium falciparum, but P. vivax and P. knowlesi can also cause severe disease. A peripheral blood slide or a rapid diagnostic test is essential since a clinical diagnosis is unreliable. Severe falciparum malaria is a multiorgan disease, and the involvement of specific organs depends on the age of the patients, although cerebral malaria and severe metabolic acidosis are common in both adult and paediatric patients. Severe anaemia, hypoglycaemia and convulsions are more frequent in children, whereas liver and lung involvement and acute kidney injury are more common in adults. Prompt treatment with parenteral artesunate is essential to save lives. Fluid bolus therapy is contra-indicated unless the patient is in hypotensive shock. In patients presenting with coma, other causes of coma, in particular hypoglycaemia, needs to be excluded. Supportive treatments for other presenting symptoms are discussed in the presentation.

Target Audience

Critical Care Doctors
Experienced or advanced Critical Care Nurses

Learning Objectives:

Upon completion of this activity, you should be able to:

  • Describe the main clinical presentations of severe malaria
  • Appreciate the essential pathophysiological differences between severe malaria and bacterial sepsis
  • Discuss the main antimalarial and supportive treatments for severe malaria

None.