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The recent article by Dorsey et al¹ highlights some of the difficulties in the prevention, diagnosis, and treatment of malaria in the United States. However, it fails to mention the critical importance of having intravenous (IV) quinidine available for the management of life-threatening chloroquine-resistant Plasmodium falciparum infection. The following case presentation underscores this problem.

Report of a Case

A 28-year-old pregnant woman presented to Grady Memorial Hospital, Atlanta, Ga, with a 4-day history of nausea, vomiting, and fever. She was a native of Ghana and had moved to Atlanta 1 week prior to admission. The estimated gestational age of the fetus was 33 weeks. Laboratory results were significant for a white blood cell count of 14.5 x 10⁹/L, hemoglobin level of 82.0 g/L, platelet count of 60.0 x 10⁹/L, lactate dehydrogenase level of 371 U/L, and a total bilirubin level of 63.27 µmol/L (3.7 mg/dL). Blood smear findings were consistent with severe . . . [Full Text of this Article]

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RELATED ARTICLE

Difficulties in the Prevention, Diagnosis, and Treatment of Imported Malaria
Grant Dorsey, Monica Gandhi, Jessica H. Oyugi, and Philip J. Rosenthal
Arch Intern Med. 2000;160(16):2505-2510.
ABSTRACT | FULL TEXT