Successful treatment of severe cerebral malaria with artificial liver blood purification technology: A case report

Plasmodium falciparum infection can lead to acute thrombocytopenia, severe hemolytic anemia, and acute liver and kidney failure, among which the fatality rate of cerebral malaria is as high as 20% to 30%. Continuous bedside blood purification technology is an important intervention measure for severe malaria. The artificial liver blood purification technology, with its multimode clearance advantage, is widely used in the treatment of critical conditions such as liver failure, sepsis, and novel coronavirus infection. We described a case of severe cerebral malaria complicated with severe liver and kidney injury, cerebral edema and heart failure. The patient was cured after treatment with artificial liver blood purification technology. A literature review was also conducted.

A 43-year-old male patient was admitted to our hospital due to fever and confusion. The patient had frequently traveled to Nigeria on business in the past 10 years. Three days ago, he developed high fever and confusion. Blood smear examination revealed infection with Plasmodium falciparum. He also suffered from acute liver and kidney function impairment, severe thrombocytopenia, coagulation dysfunction, cerebral edema, and anuria.

Peripheral blood smear, for the diagnosis of malignant malaria parasite infection.

The patient received treatments such as artemether for antimalarial parasites, artificial liver blood purification, and ICU support.

Through continuous renal replacement therapy combined with artificial liver blood purification technology for fluid management, immune complex clearance, and correction of water, electrolyte and acid-base disorders, the patient was successfully treated.

The integration of artificial liver blood purification with continuous renal replacement therapy may serve as an effective rescue therapy for severe malaria with multi-organ failure, potentially by mitigating the systemic inflammatory response and supporting organ recovery. This case highlights the potential of combined extracorporeal support in managing critical tropical infections.