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 Yeo
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.
