Fulminant Plasmodium falciparum Infection Treated With Exchange Blood Transfusion

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Abstract
A 48-year-old physician, who was not undergoing malaria chemoprophylaxis, contracted Plasmodium falciparum while working in eastern Thailand. In the hospital, he had a peak parasitemia of 72% RBCs infected, associated with CNS dysfunction. As an adjunct to chemotherapy, a double-volume whole-blood exchange transfusion was performed on the first hospital day, dropping the parasitemia to less than 1% within 32 hours. The patient's clinical condition improved, with a prompt reversal of CNS, hepatic, and renal complications. These results, combined with those in previously reported cases, suggest that exchange transfusion should be considered more generally as a life-saving procedure in P falciparum infections. (JAMA 1983;249:244-245)

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