Cerebral Malaria

exp date isn't null, but text field is

Description

Severe malaria caused by Plasmodium Falciparum. Patient may present with altered mental state, convulsions, confusion and coma. It may also present with other complications of severe malaria such as acute renal failure, DIC, Pulmonary oedema, severe anaemia, hyperparasitaemia and hypoglycaemia.

Signs and Symptoms

  • Fever, Chills, headache, nausea and vomiting, joint pains, backache, loss of appetite, abdominal pains and
  • Fever/ hypothermia, low GCS, convulsions,

Investigations

  • Malaria parasite slide, RDT, FBC, RFTs, LFTs, RBS, CT/ MRI

Treatment

  • Artesunate 4mg/kg IV or IM at the time of admission (time = 0), then at 12 hour, and 24 hour, then once per day until the patient is able to take oral medication.

Alternative treatment:

Quinine to be given in cases of suspected treatment failure to artesunate or when hypersensitivity reactions exist to artesunate;

  • Quinine dihydrochloride 20mg/ kg (loading dose) in 10% dextrose on admission, then 10mg/kg every 8 hours. Dilute Quinine in 5% dextrose and infused over 4 If patient able to tolerate orally, switch to per oral quinine;

NB: Complete treatment with Artemeter /Lumefantrine as soon as patient is able to take oral medication but not before the minimum 24 hours of parenteral treatment;

  • Paracetamol 10- 20mg/kg IV if patient is pyrexical.