TABLE 4

Severe malaria definition and treatmenta

DefinitionTreatment
Positive blood smear and at least one of the following criteria:

  • Impaired consciousness or coma

  • Severe normocytic anemia (hemoglobin < 7 g/dL)

  • Acute kidney injury

  • Acute respiratory distress syndrome

  • Hypotension

  • Disseminated intravascular coagulation

  • Spontaneous bleeding

  • Acidosis

  • Hemoglobinuria

  • Jaundice

  • Repeated generalized convulsions

  • Parasitemia ≥ 5%

Intravenous artesunate is available under an expanded-access investigational new drug protocol (call the US Centers for Disease Control and Prevention)
and
Artemether-lumefantrine, atovaquone-proguanil, doxycycline (clindamycin in pregnant women); if no other options, mefloquine

  • ↵a Severe malaria is most often caused by Plasmodium falciparum.