 |
Admit the patient and treat with IV quinidine plus doxycycline
In the presence of a diagnosis of malaria, species undetermined,
in a patient returning from Zambia, the safest approach is to
treat this as chloroquine-resistant P. falciparum. In addition,
since the patient is slow in answering questions and signs of
renal failure are present, it is best to treat this as a case of severe
malaria. The patient should be given quinidine by intravenous
infusion and doxycycline. (An additional argument for parenteral treatment
is the patient’s vomiting.) Because of the potential cardiotoxicity
of quinidine, the patient should be admitted to the intensive
care unit to allow continuous monitoring of the ECG and frequent checks
of the blood pressure. All possible efforts should be made to
have as rapidly as possible a definitive identification of the malaria
species, and a quantitative estimate of parasite density.
Page last modified : July 30, 2004
Content source: Division of Parasitic Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
|
|
|
