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Volume 17, Number 5—May 2011


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 2

Criteria for severe malaria, World Health Organization definition revised in 2000

Extreme weakness
Impaired consciousness, Glasgow Coma Scale score <9
Pulmonary edema with presence of criteria for acute respiratory distress syndrome or acute lung injury
Repeated generalized seizures, >2 within 24 h
Circulatory collapse
Systolic blood pressure <80 mmHg despite adequate volume repletion
Spontaneous bleeding and/or disseminated intravascular coagulation
Jaundice or total bilirubin >50 μmol/L
Macroscopic hemoglobinuria (if unequivocally related to malaria)
Severe anemia
Hemoglobin ,<5 g/dL
Hypoglycemia, blood glucose <2.2 mmol/L
Acidemia, pH <7.35, or acidosis, serum bicarbonate <15 mmol/L
Hyperlactatemia, arterial lactate >5 mmol/L
Acute renal failure, urine output of <400 mL/24 h and serum creatinine >265 μmol/L
Parasitemia, >4%

Main Article

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