Experience of Erythrocyte Exchange in Severe Plasmodium falciparum Malaria

Abstract

Plasmodium falciparum malaria is a type of the malaria that is common in Africa, resistant to conventional drugs and causes the most severe clinical course. In patients infected with P. falciparum, parasite load of erythrocytes is quiet high. In our clinic, in addition to anti-parasitic therapy, 18 units of erythrocyte exchange (exchange transfusion, ET) were performed on the 43-year-old patient with a diagnosis of severe malaria due to high parasite load. After 8 hours from ET, Wright and Giemsa stained peripheral blood smears were evaluated and no parasite was found in the erythrocytes of the patient. In this case, the faster reduction of parasitemia was achieved by ET. Effectiveness of ET is controversial in the treatment of malaria. However, according to this case, it was thought that performing ET in addition to anti-parasitic therapy can be lifesaving in the treatment of severe falciparum malaria having higher parasitic load.

Keywords

• Plasmodium falciparum
• Malaria
• Erythrocyte exchange
• Parasite load