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Volume 17, Number 5—May 2011

CME ACTIVITY - Research

Severe Imported Plasmodium falciparum Malaria, France, 1996–2003

Elise Seringe, Marc Thellier, Arnaud Fontanet, Fabrice Legros, Olivier Bouchaud, Thierry Ancelle, Eric Kendjo, Sandrine Houze, Jacques Le Bras, Martin Danis, Rémy DurandComments to Author , and for the French National Reference Center for Imported Malaria Study Group
Author affiliations: Author affiliations: University Pierre et Marie Curie, Paris, France (E. Seringe, M. Thellier, M. Danis); Groupe Hospitalier Pitié-Salpĕtrière, Paris (E. Seringe, M. Thellier, M. Danis); Centre National de Référence du Paludisme, Paris (M. Thellier, F. Legros, E. Kendjo, S. Houze, J. Le Bras, M. Danis, R. Durand); Institut Pasteur, Paris (E. Seringe, A. Fontanet); Conservatoire National des Arts et Métiers, Paris (A. Fontanet); Hôpital Avicenne, Bobigny, France (O. Bouchaud, R. Durand); Hôpital Cochin, Paris (T. Ancelle)

Main Article

Table 1

Criteria used before 2000 to define severe malaria, 1990 World Health Organization definition

Major criteria
Unrousable coma
Glasgow Coma Scale score of <9
Repeated generalized seizures
Circulatory collapse, systolic blood pressure <80 mmHg
despite adequate volume repletion
Pulmonary edema with presence of criteria for acute
respiratory distress syndrome or acute lung injury
Spontaneous bleeding and/or disseminated intravascular
coagulation
Acidemia, pH <7.35, or acidosis, serum bicarbonate <15
mmol/L
Severe anemia, hemoglobin <5 g/dL
Renal impairment, serum creatinine >265 μmol/L
Hypoglycemia, blood glucose, <2.2 mmol/L
Macroscopic hemoglobinuria (if unequivocally related to
malaria)
Minor criteria
Impaired consciousness but rousable
Extreme weakness
Temperature >40°C
Parasitemia >5%
Jaundice or total bilrubin >50 μmol/L

Main Article

1Additional members of the French National Reference Center for Imported Malaria Study Group who contributed data are listed in the Technical Appendix.

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