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[Severe malaria]

B Gachot1, P Ringwald

  • 1Service de maladies infectiuses et tropicales, Hôpital de l'Institut Pasteur, Paris.

La Revue Du Praticien
|October 22, 1998
PubMed
Summary
This summary is machine-generated.

Severe malaria, a leading cause of death in developing nations, involves complex pathophysiology. Optimizing supportive care for severe malaria is crucial, especially with rising antimalarial drug resistance.

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Area of Science:

  • Tropical Medicine and Infectious Diseases
  • Pathophysiology of Severe Malaria

Context:

  • Falciparum malaria is a significant global health threat, particularly in African children.
  • Parasitized erythrocyte sequestration and cytoadherence to endothelium are key pathogenic mechanisms.
  • Proinflammatory cytokines, like tumor necrosis factor, exacerbate severe disease, but coma pathophysiology is unclear.

Purpose:

  • To elucidate the pathophysiology of severe malaria, including cerebral malaria and its complications.
  • To highlight the clinical manifestations in children and non-immune adults.
  • To emphasize challenges posed by antimalarial resistance and the importance of symptomatic management.

Summary:

  • Severe malaria presents with diverse clinical features: cerebral malaria, anemia, hypoglycemia, seizures, and raised intracranial pressure in children.

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  • Adults may experience severe sepsis, shock, acute renal failure, and respiratory distress syndrome, often with bacterial coinfection.
  • Quinine remains the primary treatment for severe malaria, despite evolving antimalarial resistance.

    • Impact:

    • Understanding severe malaria pathophysiology is critical for developing targeted interventions.
    • Optimizing supportive care is essential for reducing mortality and morbidity in resource-limited settings.
    • Addressing antimalarial drug resistance is vital for effective malaria control.