TY - JOUR
T1 - Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia
AU - William, Timothy
AU - Menon, Jayaram
AU - Rajahram, Giri
AU - Chan, Leslie
AU - Ma, Gordon
AU - Donaldson, Samantha
AU - Khoo, Serena
AU - Fredrick, Charlie
AU - Jelip, Jenarun
AU - Anstey, Nicholas
AU - Yeo, Tsin
PY - 2011/7
Y1 - 2011/7
N2 - The simian parasite Plasmodium knowlesi causes severe human malaria; the optimal treatment remains unknown. We describe the clinical features, disease spectrum, and response to antimalarial chemotherapy, including artemether-lumefantrine and artesunate, in patients with P. knowlesi malaria diagnosed by PCR during December 2007-November 2009 at a tertiary care hospital in Sabah, Malaysia. Fifty-six patients had PCR-confirmed P. knowlesi monoinfection and clinical records available for review. Twenty-two (39%) had severe malaria; of these, 6 (27%) died. Thirteen (59%) had respiratory distress; 12 (55%), acute renal failure; and 12, shock. None experienced coma. Patients with uncomplicated disease received chloroquine, quinine, or artemether-lumefantrine, and those with severe disease received intravenous quinine or artesunate. Parasite clearance times were 1-2 days shorter with either artemether-lumefantrine or artesunate treatment. P. knowlesi is a major cause of severe and fatal malaria in Sabah. Artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria.
AB - The simian parasite Plasmodium knowlesi causes severe human malaria; the optimal treatment remains unknown. We describe the clinical features, disease spectrum, and response to antimalarial chemotherapy, including artemether-lumefantrine and artesunate, in patients with P. knowlesi malaria diagnosed by PCR during December 2007-November 2009 at a tertiary care hospital in Sabah, Malaysia. Fifty-six patients had PCR-confirmed P. knowlesi monoinfection and clinical records available for review. Twenty-two (39%) had severe malaria; of these, 6 (27%) died. Thirteen (59%) had respiratory distress; 12 (55%), acute renal failure; and 12, shock. None experienced coma. Patients with uncomplicated disease received chloroquine, quinine, or artemether-lumefantrine, and those with severe disease received intravenous quinine or artesunate. Parasite clearance times were 1-2 days shorter with either artemether-lumefantrine or artesunate treatment. P. knowlesi is a major cause of severe and fatal malaria in Sabah. Artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria.
UR - http://www.scopus.com/inward/record.url?scp=79959911202&partnerID=8YFLogxK
U2 - 10.3201/eid.1707.101017
DO - 10.3201/eid.1707.101017
M3 - Article
SN - 1080-6040
VL - 17
SP - 1248
EP - 1255
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 7
ER -