Volume 17, Number 5—May 2011
CME ACTIVITY
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 Durand
, and for the French National Reference Center for Imported Malaria Study Group
, and for the French National Reference Center for Imported Malaria Study GroupTable 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 |
1Additional members of the French National Reference Center for Imported Malaria Study Group who contributed data are listed in the Technical Appendix.
