Ineffectiveness of Continuous Quinidine Gluconate Infusion in the Treatment of Severe Chloroquine-Resistant Plasmodium Falciparum Malaria

1988 ◽  
Vol 22 (11) ◽  
pp. 883-885 ◽  
Author(s):  
Gary K. Matsuura ◽  
Lucinda A. Chan
Keyword(s):  
Plasmodium Falciparum ◽  
Disease Control ◽  
Continuous Infusion ◽  
Falciparum Malaria ◽  
Plasmodium Falciparum Malaria ◽  
Viable Alternative ◽  
Loading Dose ◽  
Drug Of Choice ◽  
Life Threatening ◽  
The U.S

The drug of choice in the treatment of chloroquine-resistant Plasmodium falciparum malaria is parenteral quinine dihydrochloride. Due to limited use, the drug is not commercially available in the U.S. and must be obtained through the Centers for Disease Control (CDC) in Atlanta, Georgia. As an alternative, the CDC has developed a protocol to treat P. falciparum malaria with parenteral quinidine gluconate. Following this protocol, a 10 mg/kg loading dose of quinidine gluconate followed by a 0.02 mg/kg/min continuous infusion was administered to a 53-year-old man with severe life-threatening chloroquine-resistant P. falciparum malaria. Although the patient described did not survive, the use of parenteral quinidine gluconate still appears to be a viable alternative to parenteral quinine dihydrochloride in the treatment of severe chloroquine-resistant P. falciparum malaria.

scholarly journals Identifying the Components of Acidosis in Patients With Severe Plasmodium falciparum Malaria Using Metabolomics

2018 ◽  
Vol 219 (11) ◽  
pp. 1766-1776 ◽  
Author(s):  
Stije J Leopold ◽  
Aniruddha Ghose ◽  
Erik L Allman ◽  
Hugh W F Kingston ◽  
Amir Hossain ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Intestinal Barrier ◽  
Plasmodium Falciparum Malaria ◽  
Intestinal Barrier Function ◽  
Life Threatening ◽  
Plasma Marker ◽  
Severe Falciparum Malaria

AbstractBackgroundAcidosis in severe Plasmodium falciparum malaria is associated with high mortality, yet the pathogenesis remains incompletely understood. The aim of this study was to determine the nature and source of metabolic acids contributing to acidosis in patients with severe falciparum malaria.MethodsA prospective observational study was conducted to characterize circulating acids in adults with P. falciparum malaria (n = 107) and healthy controls (n = 45) from Bangladesh using high-resolution liquid chromatography–mass spectrometry metabolomics. Additional in vitro P. falciparum culture studies were performed to determine if parasites release the acids detected in plasma from patients with severe malaria acidosis.ResultsWe identified previously unmeasured plasma acids strongly associated with acidosis in severe malaria. Metabolomic analysis of P. falciparum parasites in vitro showed no evidence that these acids are released by the parasite during its life cycle. Instead, 10 of the plasma acids could be mapped to a gut microbial origin. Patients with malaria had low L-citrulline levels, a plasma marker indicating reduced gut barrier integrity. Longitudinal data showed the clearance of these newly identified acids was delayed in fatal cases.ConclusionsThese data suggest that a compromise in intestinal barrier function may contribute significantly to the pathogenesis of life-threatening acidosis in severe falciparum malaria.Clinical Trials RegistrationNCT02451904.

scholarly journals Rapid diagnostic test negative Plasmodium falciparum malaria in a traveller returning from Ethiopia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Stefan Schlabe ◽  
Ingrid Reiter-Owona ◽  
Tamara Nordmann ◽  
Ramona Dolscheid-Pommerich ◽  
Egbert Tannich ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Falciparum Malaria ◽  
False Negative ◽  
Plasmodium Falciparum Malaria ◽  
Negative Results ◽  
First Case ◽  
False Negative Results ◽  
Genes Encoding ◽  
Life Threatening ◽  
And Control

Abstract Background Plasmodium falciparum strains with mutations/deletions of the genes encoding the histidine-rich proteins 2/3 (pfhrp2/3) have emerged during the last 10 years leading to false-negative results in HRP2-based rapid diagnostic tests (RDTs). This can lead to unrecognized infections in individuals and to setbacks in malaria control in endemic countries where RDTs are the backbone of malaria diagnostics and control. Case description Here the detection of a pfhrp2/3-negative P. falciparum infection acquired in Ethiopia by a 63-year old female traveller is presented. After onset of symptoms during travel, she was first tested negative for malaria, most probably by RDT, at a local hospital in Harar, Ethiopia. Falciparum malaria was finally diagnosed microscopically upon her return to Germany, over 4 weeks after infection. At a parasite density of approximately 5387 parasites/µl, two different high-quality RDTs: Palutop + 4 OPTIMA, NADALRMalaria PF/pan Ag 4 Species, did not respond at their respective P. falciparum test lines. pfhrp2/3 deletion was confirmed by multiplex-PCR. The patient recovered after a complete course of atovaquone and proguanil. According to the travel route, malaria was acquired most likely in the Awash region, Central Ethiopia. This is the first case of imported P. falciparum with confirmed pfhrp2/3 deletion from Ethiopia. Conclusion HRP2-negative P. falciparum strains may not be recognized by the presently available HRP2-based RDTs. When malaria is suspected, confirmation by microscopy and/or qPCR is necessary in order to detect falciparum malaria, which requires immediate treatment. This case of imported P. falciparum, non-reactive to HRP2-based RDT, possibly underlines the necessity for standardized, nationwide investigations in Ethiopia and should alert clinicians from non-endemic countries to the possibility of false-negative RDT results which may increase in returning travellers with potentially life-threatening infections.

scholarly journals The Use of Activated Protein C in Severe Plasmodium Falciparum Malaria

2007 ◽  
Vol 35 (3) ◽  
pp. 428-432 ◽  
Author(s):  
L. G. Rankin ◽  
D. L. H. Austin
Keyword(s):  
Plasmodium Falciparum ◽  
Severe Sepsis ◽  
Falciparum Malaria ◽  
Protein C ◽  
Multiorgan Failure ◽  
Activated Protein C ◽  
Severe Infection ◽  
Plasmodium Falciparum Malaria ◽  
Peripheral Hospital ◽  
Life Threatening

A 56-year-old man presented to a peripheral hospital in New Zealand with severe Plasmodium falciparum malaria with cerebral involvement and subsequently developed multi-system organ failure. Activated protein C was used in an attempt to stop the cascade of events into multiorgan failure. Severe infection with P. falciparum is life-threatening and appears to activate a hypercoagulable state similar to that of severe sepsis. Activated protein C is currently used in the treatment of severe sepsis and may provide a new adjuvant therapy for severe P. falciparum malaria.

scholarly journals Malaria in the Time of COVID-19: Do Not Miss the Real Cause of Illness

2021 ◽  
Vol 6 (2) ◽  
pp. 40
Author(s):  
Johannes Jochum ◽  
Benno Kreuels ◽  
Egbert Tannich ◽  
Samuel Huber ◽  
Julian Schulze zur Wiesch ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Severe Acute Respiratory Syndrome ◽  
Falciparum Malaria ◽  
Medical Management ◽  
Cognitive Biases ◽  
Plasmodium Falciparum Malaria ◽  
Current Situation ◽  
The Real ◽  
Life Threatening

We report a case of Plasmodium falciparum malaria in a patient asymptomatically co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the current ongoing coronavirus pandemic, co-infections with unrelated life-threatening febrile conditions may pose a particular challenge to clinicians. The current situation increases the risk for cognitive biases in medical management.

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