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Volume 17, Number 7—July 2011

Research

Severe Plasmodium knowlesi Malaria in a Tertiary Care Hospital, Sabah, Malaysia

Timothy William, Jayaram Menon, Giri Rajahram, Leslie Chan, Gordon Ma, Samantha Donaldson, Serena Khoo, Charlie Fredrick, Jenarun Jelip, Nicholas M. Anstey, and Tsin Wen YeoComments to Author 
Author affiliations: Author affiliations: Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysian Borneo (T. William, J. Menon, G. Rajahram, L. Chan, G. Ma, S. Donaldson, S. Khoo, C. Fredrick); Department of Health, Kota Kinabalu, Malaysia (J. Jelip); Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia (N.M. Anstey, T.W. Yeo); Royal Darwin Hospital, Darwin (N.M. Anstey, T.W. Yeo)

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Table 3

Details of patients with severe Plasmodium knowlesi malaria, Sabah, Malaysia, 2007–2009*

Patient no. Age, y/ sex Severity† Parasite count Platelets/ µL Blood products ICU Inotropes Ventilation Dialysis Treatment Outcome
P. knowlesi only
1 76/M 1, 6, 7 3 17,000 Plt Y N N N Artesunate S
2 22/M 4, 7 3 38,000 Bld Y Y Y N Quinine S
3 29/M 2 4 16,000 Bld, Plt Y N Y Y Quinine S
4 76/F 1, 2, 3, 4, 6, 7 4 42,000 Bld Y Y Y Y Quinine D
5 50/M 2, 4 2 60,000 Bld Y Y N Y Quinine S
6 55/M 2, 4, 7 4 42,000 N Y Y N N Quinine S
7 49/M 1 4 78,000 N Y N N N Quinine S
8 38/F 2 4 29,000 Bld Y N N Y Quinine S
9 65/M 3, 4 3 17,000 N N N N N Quinine S
10 70/F 2, 4, 6, 7 4 48,000 Bld Y Y Y Y Quinine S
11 65/F 1, 2, 4, 6, 7 4 26,000 Bld, FFP Y Y Y Y Quinine D
12 75/F 4, 6 3 22,000 N N Y N N Artesunate S
13 69/F 7 2 130,000 N N N N N Artesunate S
14 57/M 1, 2, 3, 4, 6, 7 4 35,000 Bld, Plt, FFP Y Y Y Y Artesunate D
15 60/M 1 4 37,000 N N N N N Quinine S
16 44/M 1 3 61,000 N N N N N Artesunate S
17 54/M 4, 7 2 72,000 N Y Y N N Quinine S
18 69/M 1, 2 3 41,000 Bld Y N N Y Quinine S
19 84/F 2, 5, 7 2 34,000 N N N Y N Quinine D
20 54/F 2, 4, 7 3 12,000 Bld, Plt Y Y Y Y Artesunate S
21 56/M 4, 7 4 28,000 N N Y Y N Quinine D
22
46/M
1, 2, 7
4
16,000
N
Y
Y
Y
Y
Quinine
D
P. vivax +
P. knowlesi 48/M 1, 2, 6 2 24,000 N Y N N Y Artesunate S
ND 28/M 7 3 80,000 N Y N Y N Artesunate S

*ICU, intensive care unit; Bld, blood; Plt, platelets; Y, yes; N, no; S, survived; D, died; FFP, fresh frozen plasma; ND, none detected.
†Severity criteria: 1, hyperbilirubinemia; 2, acute renal failure; 3, hypoglycemia; 4, shock; 5, blackwater fever; 6, acidosis; 7, respiratory distress.

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