Successful Oral Therapy for Severe Falciparum Malaria: The World Health Organization Criteria Revisited

Eran Kopel Department of Internal Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer, Israel

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Enbal Marhoom Department of Internal Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer, Israel

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Yechezkel Sidi Department of Internal Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer, Israel

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Eli Schwartz Department of Internal Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer, Israel

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We report a successful treatment of severe falciparum malaria in a non-immune adult patient with 30% parasitemia treated with the 6-dose oral regimen of artemether plus lumefantrine combination therapy alone. We have also retrospectively searched our tertiary center's database for similar cases and we have found two additional severe malaria cases, resolved uneventfully with oral regimen. These cases might indicate a need to specifically address the definition of severe and complicated malaria in non-immune patients either in designated guidelines or as an explicit addition to the historical World Health Organization criteria.

Author Notes

*Address correspondence to Eli Schwartz, Internal Medicine Department C, The Chaim Sheba Medical Center, Tel Hashomer, Israel 52621. E-mail: eli.schwartz@sheba.health.gov.il

Authors' addresses: Eran Kopel, Enbal Marhoom, and Yechezkel Sidi, Department of Internal Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel, Emails: eran.kopel@mail.huji.ac.il, enbalm@sheba.health.gov.il, and ysidi@sheba.health.gov.il. Eli Schwartz, The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer, Israel, E-mail: eli.schwartz@sheba.health.gov.il.

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