Background Severe imported Plasmodium falciparum malaria is a potentially life-threatening disease with a reported mortality rate of 5–10% when patients are admitted to the Intensive Care Unit. Methods To retrospectively review the clinical aspects, the value of severity predictive scores and the management of patients with severe P. falciparum malaria admitted to an ICU in Milano, Italy between January 2010 and December 2015. Results Twelve patients were included: seven were male and five female with a median age of 43 years. All were initially treated with intravenous quinine. Median parasitaemia upon admission was 14,5% (range 1–20%). At the time of ICU admission, 3 patients (25%) had 5 or more World Health Organization criteria for severe malaria while another 6 of them developed one or more of the latter during their stay in ICU. Five required mechanical ventilation because of respiratory failure due to ARDS. Four patients required renal replacement therapy. Three patients underwent blood exchange transfusion. All patients survived. Conclusions Our retrospective evaluation of adults patients admitted to the ICU with severe imported P. falciparum malaria demonstrated a favourable outcome. Severity predictive scores currently in use probably overestimate the risk of malaria mortality in patients treated in health care systems of high income countries.

Severe Plasmodium falciparum malaria in the intensive care unit : A 6-year experience in Milano, Italy / S. Antinori, A. Corona, A. Castelli, R. Rech, B. Borghi, C. Giannotti, R. Colombo, T. Fossali, E. Ballone, C.A. Minari, A. Perotti, P. Bergomi, L. Galimberti, L. Milazzo, D. Ricaboni, D. Scorza, R. Grande, F. Genderini, M. Ieri, F. Raimondi, E. Catena, M. Galli, M. Corbellino. - In: TRAVEL MEDICINE AND INFECTIOUS DISEASE. - ISSN 1477-8939. - 17(2017 Jun), pp. 43-49. [10.1016/j.tmaid.2017.05.012]

Severe Plasmodium falciparum malaria in the intensive care unit : A 6-year experience in Milano, Italy

S. Antinori
Primo
Writing – Review & Editing
;
A. Corona;B. Borghi;R. Colombo;T. Fossali;E. Ballone;C.A. Minari;A. Perotti;D. Ricaboni;M. Galli;
2017-06

Abstract

Background Severe imported Plasmodium falciparum malaria is a potentially life-threatening disease with a reported mortality rate of 5–10% when patients are admitted to the Intensive Care Unit. Methods To retrospectively review the clinical aspects, the value of severity predictive scores and the management of patients with severe P. falciparum malaria admitted to an ICU in Milano, Italy between January 2010 and December 2015. Results Twelve patients were included: seven were male and five female with a median age of 43 years. All were initially treated with intravenous quinine. Median parasitaemia upon admission was 14,5% (range 1–20%). At the time of ICU admission, 3 patients (25%) had 5 or more World Health Organization criteria for severe malaria while another 6 of them developed one or more of the latter during their stay in ICU. Five required mechanical ventilation because of respiratory failure due to ARDS. Four patients required renal replacement therapy. Three patients underwent blood exchange transfusion. All patients survived. Conclusions Our retrospective evaluation of adults patients admitted to the ICU with severe imported P. falciparum malaria demonstrated a favourable outcome. Severity predictive scores currently in use probably overestimate the risk of malaria mortality in patients treated in health care systems of high income countries.
imported malaria; Intensive care unit; Plasmodium falciparum; Quinine; severe malaria; public health, environmental and occupational health; infectious diseases
Settore MED/17 - Malattie Infettive
Article (author)
File in questo prodotto:
File Dimensione Formato  
ManuscriptTMAID-D-17-00009R1.pdf

accesso aperto

Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 148.73 kB
Formato Adobe PDF
148.73 kB Adobe PDF Visualizza/Apri
TravelMedicineInfectiousDisease_SeverePlasmodium_2017.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 274.43 kB
Formato Adobe PDF
274.43 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/556735
Citazioni
  • ???jsp.display-item.citation.pmc??? 4
  • Scopus 9
  • ???jsp.display-item.citation.isi??? 10
social impact