A Stitch in Time Saves Nine: Planning for Artesunate Supply with Malaria on the Rise

Abstract

Background: Malaria is extremely rare in the United States. Physicians should not only be familiar with signs and symptoms, but also be aware of the available resources at their respective institutions to be able to effectively treat it.

Presentation: 52-year-old female presented with worsening generalized fatigue. Vitals were stable. Labs were significant for anemia and thrombocytopenia. Peripheral smear showed ring formed parasitic trophozoites consistent with Plasmodium falciparum. Due to unavailability of antimalarial agents at our hospital, the patient was transferred to a tertiary care center. Patient was started on IV artesunate therapy. Repeat smear after 3 days showed <1% parasitemia after 3 days and the patient was discharged with artemether/lumefantrine for 3 additional days, resulting in full recovery.

Conclusion: This case gives a unique insight into the challenges that hospitals in non-endemic regions may have to face, in terms of diagnosing malaria and having access to antimalarial agents.

Keywords: Artesunate; Malaria; Non-endemic region; Plasmodium falciparum.

Fig. 1

Image of peripheral blood smear showing normochromic, normocytic anemia with numerous ring-formed parasitic trophozoites, and occasional cluster schizont forms within RBC consistent with malaria.

Fig. 2

Image of peripheral blood smear showing normochromic, normocytic anemia with numerous ring-formed parasitic trophozoites, and occasional cluster schizont forms within RBC consistent with malaria.

Fig. 3

Image of peripheral blood smear showing normochromic, normocytic anemia with numerous ring-formed parasitic trophozoites, and occasional cluster schizont forms within RBC consistent with malaria.