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• W2893729290 abstract "• Severe malaria accounts for approximately 10% of all cases of imported malaria in France, mainly due to Plasmodium falciparum . • On the basis of WHO criteria, the French definition of severe imported malaria in adults has been progressively adjusted to the European healthcare level. • Management of severe imported malaria is an emergency, which must be initially conducted in the intensive care unit. • Anti-infective treatment is now based on intravenous artesunate, which must be available in every hospital. • Critical care management of organ failure is essential, particularly for the most severe presentations. Severe malaria accounts for approximately 10% of all cases of imported malaria in France; cases are mainly due to Plasmodium falciparum , while other Plasmodium species are possible but uncommon ( P . vivax , P . knowlesi , P . malariae , and P . ovale ). On the basis of WHO criteria for endemic areas, the French criteria defining severe imported malaria in adults have been progressively adapted to the European healthcare level. Management of severe imported malaria is a diagnostic and treatment emergency and must be initially conducted in the intensive care unit. Anti-infective treatment is now based on intravenous artesunate, which must be available in every hospital of the country likely to receive severe imported malaria patients. Intravenous quinine is thus used as a second-line treatment and is restricted to limited indications. Critical care management of organ failure is essential, particularly in patients presenting with very severe malaria. To date, no adjunctive therapy (including exchange transfusion) has demonstrated clear beneficial effects. En France, le paludisme grave d’importation concerne environ 10 % des accès palustres et implique majoritairement Plasmodium falciparum , beaucoup plus rarement P . vivax ou P . knowlesi , et exceptionnellement P . malariae et P . ovale . Sur le modèle de la définition du paludisme grave de l’Organisation mondiale de la santé définie pour les zones d’endémie palustre, la définition française du paludisme grave d’importation de l’adulte a été progressivement adaptée aux données spécifiques et au contexte de soin européen. La prise en charge du paludisme grave est une urgence diagnostique et thérapeutique. Elle doit être réalisée initialement en réanimation. Le traitement curatif du paludisme grave d’importation repose maintenant sur l’artésunate intraveineux, qui doit être disponible dans chaque hôpital susceptible de recevoir ces patients. Dès lors, la quinine intraveineuse devient un traitement de seconde ligne réservé à certaines indications particulières. La prise en charge symptomatique des défaillances d’organes est primordiale, notamment au cours des présentations les plus graves. À ce jour, aucun traitement adjuvant (dont l’exsanguino-transfusion) n’a prouvé son efficacité en pratique clinique." @default.
• W2893729290 created "2018-10-05" @default.
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• W2893729290 date "2020-03-01" @default.
• W2893729290 modified "2023-10-18" @default.
• W2893729290 title "Management of severe imported malaria in adults" @default.
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