[Extracorporeal support treatment in severe malaria]

Area of Science:

• Intensive Care Medicine
• Infectious Diseases
• Nephrology

Background:

• Severe malaria presents with organ involvement or hyperparasitemia, carrying a 100% mortality rate without timely intervention.
• Extracorporeal therapy is a potentially valuable tool for managing organ dysfunction in severe malaria cases, despite limited literature.
• Established criteria guide early monitoring of severe malaria patients in intensive care settings.

Observation:

• A 36-year-old male diagnosed with severe malaria exhibited a poor response to intravenous artesunate.
• The patient developed hyperbilirubinemia with encephalopathy, acute kidney injury, and pulmonary edema, necessitating advanced support.
• Sequential extracorporeal treatments including plasma filtration adsorption, high-exchange plasmapheresis, and continuous hemodiafiltration were initiated.

Findings:

• The patient's condition stabilized following sequential extracorporeal therapy.
• Extracorporeal support provided crucial time for definitive antimalarial treatment to reduce parasitemia.
• The integrated approach demonstrated a favorable clinical evolution.

Implications:

• Timely and expert application of extracorporeal support is effective in managing rapidly evolving organ failure in severe malaria.
• This case highlights the utility of sequential extracorporeal therapies as a safe and effective adjunct in critical care for severe malaria.
• Extracorporeal techniques can stabilize patients, allowing antimalarial treatments to become effective and reduce parasitemia.