Severe Malaria Treatment in the United States at the Precipice
Authors: Rebecca A. Krey, Mark A. Travassos
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions3 September 2019Severe Malaria Treatment in the United States at the PrecipiceRebecca A. Krey, MD and Mark A. Travassos, MD, MScRebecca A. Krey, MDBoston Children's Hospital, Boston, Massachusetts (R.A.K.)Search for more papers by this author and Mark A. Travassos, MD, MScUniversity of Maryland School of Medicine, Baltimore, Maryland (M.A.T.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-1144 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail You are called about a febrile 20-year-old man in the emergency department who has just returned from Cameroon. Your worst fears are confirmed: The examination reveals an altered mental status, and his blood smear shows that 7% of his erythrocytes are infected with the malaria parasite Plasmodium falciparum. Such a presentation of severe malaria can have mortality of more than 50% (1). Prompt treatment improves outcomes—mortality is highest in the first 24 hours after presentation (1). The patient is transferred to the intensive care unit to begin treatment with parenteral quinidine gluconate, the only U.S. Food and Drug Administration (FDA)–approved ...References1. World Health Organization. Guidelines for the Treatment of Malaria. 3rd ed. Geneva: World Health Organization; 2015. Google Scholar2. U.S. Food and Drug Administration. FDA Drug Shortages. Silver Spring, MD: U.S. Food and Drug Administration. Accessed at www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Quinidine+Gluconate+Injection&st=d&tab=tabs-2 on 24 March 2019. Google Scholar3. Centers for Disease Control and Prevention (CDC). Availability and use of parenteral quinidine gluconate for severe or complicated malaria. MMWR Morb Mortal Wkly Rep. 2000;49:1138-40. [PMID: 11190119] MedlineGoogle Scholar4. Mace KE, Arguin PM, Tan KR. Malaria surveillance - United States, 2015. MMWR Surveill Summ. 2018;67:1-28. [PMID: 29723168] doi:10.15585/mmwr.ss6707a1 CrossrefMedlineGoogle Scholar5. Centers for Disease Control and Prevention. Availability of Intravenous Artesunate for Treatment of Severe Malaria in the United States. Atlanta: Centers for Disease Control and Prevention; 2019. Accessed at www.cdc.gov/malaria/new_info/2019/artesunate_2019.html on 23 March 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: Boston Children's Hospital, Boston, Massachusetts (R.A.K.)University of Maryland School of Medicine, Baltimore, Maryland (M.A.T.)Note: Both authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1144.Corresponding Author: Mark Travassos, MD, MSc, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 West Baltimore Street, Room 480, Baltimore, MD 21201; e-mail, [email protected]umaryland.edu.Current Author Addresses: Dr. Krey: Division of General Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115.Dr. Travassos: Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 West Baltimore Street, Room 480, Baltimore, MD 21201.Author Contributions: Conception and design: R.A. Krey, M.A. Travassos.Analysis and interpretation of the data: R.A. Krey, M.A. Travassos.Drafting of the article: R.A. Krey, M.A. Travassos.Critical revision of the article for important intellectual content: M.A. Travassos.Final approval of the article: R.A. Krey, M.A. Travassos.Collection and assembly of data: R.A. Krey, M.A. Travassos.This article was published at Annals.org on 20 August 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Severe Malaria in the United States Chandy C. John Treatment of Severe Malaria in the United States Emilia M. Sordillo , Melissa Gitman , Michael D. Nowak , and Alberto E. Paniz Mondolfi Metrics Cited byIntravenous Artesunate for the Treatment of Severe Imported Malaria: Implementation, Efficacy, and Safety in 1391 PatientsA self-sustained nanoplatform reverses TRAIL-resistance of pancreatic cancer through coactivating of exogenous and endogenous apoptotic pathwayMalaria Surveillance — United States, 2017Treatment of Severe Malaria in the United StatesChandy C. John, MD, MSTreatment of Severe Malaria in the United StatesEmilia M. Sordillo, MD, PhD, Melissa Gitman, MD, MPH, Michael D. Nowak, MD, and Alberto E. Paniz Mondolfi, MD, PhD 3 September 2019Volume 171, Issue 5Page: 362-363KeywordsAntimalarialsArtesunateBloodFood and Drug AdministrationGlobal healthHematologic testsInfectious diseasesMalariaPatient advocacyVaccine development ePublished: 20 August 2019 Issue Published: 3 September 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...