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Related Experiment Video

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Ookluc: A Plasmodium berghei Line for Identifying Transmission-blocking Compounds

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Algid malaria treated with early goal-directed therapy.

David F Gaieski¹, Jason D Goldman, David L Holtzman

¹Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. gaieskid@uphs.upenn.edu

The American Journal of Emergency Medicine

|July 17, 2012

Summary

Algid malaria, a severe form of malaria causing shock, requires optimal fluid resuscitation. This case study shows successful large-volume fluid resuscitation in a patient with imported Plasmodium falciparum malaria, challenging current volume restriction strategies.

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Published on: November 2, 2018

Area of Science:

Infectious Diseases
Critical Care Medicine
Tropical Medicine

Background:

Severe malaria, particularly algid malaria presenting with circulatory shock, is increasingly encountered in non-endemic regions.
The optimal fluid resuscitation strategy for algid malaria remains undefined, with some advocating for volume restriction to prevent edema.

Observation:

A young woman with imported Plasmodium falciparum malaria presented with fever, hypotension, and malaise.
She received 5.5 L of normal saline and norepinephrine for resuscitation, alongside antimalarial therapy and antibiotics.

Findings:

The patient experienced rapid reversal of circulatory shock and clearance of parasitemia within 48 hours.
Successful management was achieved with aggressive fluid resuscitation, hemodynamic optimization, and early treatment.

Implications:

This case challenges the conventional approach of cautious fluid resuscitation in algid malaria.
Further research, including case series and prospective trials, is needed to establish definitive fluid resuscitation guidelines for severe malaria with shock.