[Severe malaria in Black Africa]

Severe and complicated malaria is a fatal from a human Plasmodium falciparum infection. In clinical practice cerebral malaria in children, with unrousable coma, hyperthermia, generalized convulsions, frequently hypoglycemia, is different of severe in non immunized adults resulting in multiple organ failure with degree of impaired consciousness less important. Specific treatment requires quinine with loading dose: 16.7 mg/kg then 8.3 mg/kg every 8 hours for 7 days. Symptomatic therapy, artificial ventilation in particular is indispensable. Recovery is usual in children although neurological sequelae are frequent. In adults evolution is often complicated with pulmonary edema, aggravation of coma, nosocomial infection, and sometimes late multiple organ failure.