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Volume 17, Number 5—May 2011
Synopsis

Intravenous Artesunate for Severe Malaria in Travelers, Europe

Thomas ZollerComments to Author , Thomas Junghanss, Annette Kapaun, Ida Gjørup, Joachim Richter, Mats Hugo-Persson, Kristine Mørch, Behruz Foroutan, Norbert Suttorp, Salih Yürek, and Holger Flick
Author affiliations: Author affiliations: Charité Universitätsmedizin, Berlin, Germany (T. Zoller, N. Suttorp, S. Yürek, H. Flick); Universitätsklinikum Heidelberg, Heidelberg, Germany (T. Junghanss, A. Kapaun); The State University Hospital, Copenhagen, Denmark (I. Gjørup); Universitätsklinikum Düsseldorf, Düsseldorf, Germany (J. Richter); Hospital of Helsingborg, Helsingborg, Sweden (M. Hugo-Persson); Haukeland University Hospital, Bergen, Norway (K. Mørch); Armed Forces Hospital, Berlin (B. Foroutan)

Main Article

Table

Laboratory test results for 6 patients with posttreatment hemolysis who had been treated with intravenous artesunate for severe malaria, Europe, January 2006–June 2010*

Patient no. Initial parasitemia level, % Levels
at first examination
Treatment duration, d Parasite clearance, d Levels
at end of treatment
Day of diagnosis of hemolysis† Levels at diagnosis of hemolysis
Other test results
Hb, g/dL LDH, U/L Hb, g/dL LDH, U/L Hb, g/dL LDH, U/L
6
30
11.3
765
7
4
7.7
317
15
5.7
1,437
Coombs negative, reticulocytes 10.2%, G6PD deficiency ruled out
7
20
13.2
1,359
7
7
8.2
NA
32‡
6.1
805
None
9
30
13.4
1,033
4
5
7.6
650
19‡
5.3
672
None
11
4
13.4
904
7
2
9.8
311
15
7.8
660
Standard reticulocyte count
23
9
15.5
490
4
2
11.1
571
15
5.7
1,489
Reticulocytes >2× upper reference value, haptoglobin <0.1g/L, Coombs negative
25 10 14.2 570 3 NA 7.8 454 16‡ 5.8 444 Reticulocytes 3× upper reference value, haptoglobin <0.08 g/L (day14), G6PD deficiency ruled out

*Hb, hemoglobin; LDH, lactate dehydrogenase; G6PD, gluose-6-phosphate dehydrogenase; NA, not available.
†After first dose of artesunate.
‡Patients had persistent hemolytic activity after the end of malaria treatment.

Main Article

Page created: August 09, 2011
Page updated: August 09, 2011
Page reviewed: August 09, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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