[Severe imported malaria in adults]

Abstract

Severe malaria is characterized by the presence of asexual forms of Plasmodium falciparum in the blood and the presence of one or more OMS 2000 criterion. Imported malaria is defined as malarial infection acquired in an endemic country (often in sub-Saharan Africa) and treated in France. The largest patient group includes African patients, long-term residents in France, coming back from a vacation in their native country. In non-immunized adults, severe malaria causes multiple organe failure such as severe Gram-negative sepsis, with variable degrees of altered mental status. Severe sepsis is treated in an intensive care unit (mechanically assisted ventilation, kidney dialysis, vasoconstrictors...). Intravenous quinine is the reference treatment, but artemisinin derivatives (arthemeter and artesunate) are the most rapidly acting antimalarial drugs.