Exchange transfusion and quinine levels in falciparum malaria
Hall, A.P.
Acta Leidensia 55: 121-128
1987
ISSN/ISBN: 0065-1362 PMID: 3321827 Document Number: 300507
A 38-year-old woman was admitted with a reported 80% falciparum parasitaemia acquired in Kenya. 3 h after admission and folowing administration of 6 mg base kg dose of iv quinine, she received 3.5 litres (7 units) whole blood exchanged over 2 h which reduced the actual parasitaemia from 26 to 5% in the extracted blood. Further doses of quinine every 12 h (maximum 12 mg day) steadily reduced the parasitaemia to zero in 6 days. The therapeutic level of plasma quinine ranged between 10.3 and 25.6 micro mol/ml (3-8 mg). Anaemia and confusion improved after further blood transfusion, given 4 days after the parasitaemia had been eliminated. The use of exchange transfusion in patients with severe falciparum malaria is discussed.